Perfil Neurocognitivo de una cohorte de menores de edad con vivencias de maltrato infantil / Neuropsychological profile of a cohort of children victims of child abuse

El maltrato infantil (MI) es un problema multidimensional. El estrés crónico producido por dicho fenómeno afecta el desarrollo cerebral de niños, niñas y adolescentes (NNA), incidiendo negativamente en la evolución de diversos aspectos del desarrollo, condicionando su vida futura. El objetivo de este estudio es analizar el desempeño sociocognitivo de NNA que han vivenciado MI, mediante el análisis de las funciones del neurodesarrollo, evaluado con subpruebas de la NEPSY II. Se analizan funciones ejecutivas y percepción social, bases del razonamiento y adaptación social. Se estudia el desempeño de 14 de NNA pertenecientes a un Programa de la Fundación Súmate, cuya Misión es la recuperación de la escolaridad NNA que han visto alterado el curso de su desarrollo por MI. Los resultados dan cuenta de alteraciones cerebrales asociadas al MI, las que se evidencian en un deficitario desarrollo funcional de las variables estudiadas. Existe grave descenso en los procesos y subprocesos del funcionamiento ejecutivo. En relación con la percepción social, la muestra estudiada presenta un mejor desarrollo, el que desciende a medida que aumenta la edad. Las funciones estudiadas tienen directa relación con el razonamiento cognitivo y desarrollo socio adaptativo, bases sobre las que se estructura el desarrollo académico. Los hallazgos, refuerzan la urgencia de abordar esta sensible realidad desde la práctica médica en la atención primaria y especializada. Los resultados también son de utilidad para orientar el desarrollo de políticas públicas que efectivamente contribuyan al progreso de nuestro país.

Abstract. Child maltreatment (MI) is a multidimensional problem. The chronic stress produced by this phenomenon affects the brain development of children and adolescents (NNA), negatively affecting the evolution of various aspects of development, conditioning their future life. The objective of this study is to analyze the sociocognitive performance of children and adolescents who have experienced IM, through the analysis of the performance of neurodevelopmental functions, evaluated through subtests of the NEPSY II. Executive functions and social perception, reasoning bases and social adaptation are studied. The performance of 14 NNA belonging to a Fundación Súmate Program is studied, whose mission is the recovery of NNA schooling that has seen the course of their development altered by IM. The results show brain alterations associated with MI, evidenced in a deficient functional development of the variables studied. There is a serious decline in the processes and threads of executive functioning. In relation to social perception, the studied sample presents a better development, which decreases as age increases. The functions studied are directly related to cognitive reasoning and socio-adaptive development, based on which academic development is structured. The findings reinforce the urgency of addressing this sensitive reality from medical practice in primary and specialized care. The results are also useful to guide the development of public policies that effectively contribute to the progress of our country.

Juego, plasticidad cerebral y habilidades cognitivas / Game, brain plasticity and cognitive skills

La actividad de jugar es importante dentro del desarrollo humano, mientras se juega, se ponen en práctica distintas habilidades cognitivas en interacción con el funcionamiento de sistemas sensoriales y el sistema motor del cuerpo, lo cual se asocia a la construcción de aprendizajes. Jugar es una actividad que facilita comprender cómo es el mundo y cómo nos integramos en él. El presente artículo tiene como objetivo desarrollar una reflexión sobre la relación del juego con la plasticidad cerebral y el desarrollo de habilidades cognitivas. La hipótesis se centra en destacar el juego como una actividad que estimula la plasticidad cerebral y facilita el fortalecimiento de las habilidades cognitivas en todas las etapas del ciclo vital (no exclusivamente en la infancia). La guía de la cavilación consistió en una revisión del concepto de juego relacionado con conceptos de aprovechamiento de la plasticidad cerebral y estimulación de habilidades mentales. El propósito que ha orientado el artículo es convocar a la reflexión sobre la concepción y práctica del juego, con la intención de sumar a posicionar la actividad de jugar como una estrategia valiosa en los procesos de aprendizaje. El interés de los resultados se centra en dar sustento teórico a la acción de promover cada vez más la inclusión del juego en las intervenciones profesionales, en los procesos educativos y en las actividades de la vida cotidiana. La conclusión a la que se llega es que jugar resulta una excelente estrategia para facilitar la expresión de la plasticidad cerebral y las habilidades cognitivas.

The activity of playing is important within human development, while playing, different cognitive skills are put into practice in interaction with the functioning of sensory systems and the body's motor system, which is associated with the construction of learning. Playing is an activity thatmakes it easier to understand what the world is like and how we integrate ourselves into it. The present article aims to develop a reflection on the relationship between play and brain plasticity and the development of cognitive abilities. The hypothesis focuses on highlighting play as an activity that stimulates brain plasticity and facilitates the strengthening of cognitive abilities at all stages of the life cycle (not exclusively in childhood). The musing guide consisted of a review of the concept of play related to concepts of making use of brain plasticity and stimulating mental abilities. The purpose of the article is to call for reflection on the conception and practice of the game, with the intention of adding to position the activity of playing as a valuable strategy in the learning processes. The interest of the results is centered on giving theoretical support to the action of increasingly promoting the inclusion of the game in professional interventions, in educational processes and in activities of daily life. The conclusion reached is that playing is an excellent strategy to facilitate the expression of brain plasticity and cognitive abilities.

Differences of Structural Plasticity between Hemispheres during Rehabilitation for Subacute Stroke / 中国康复理论与实践

Objective:To explore the differences in plasticity mechanism of cortical structure between hemispheres during rehabilitation for stroke patients at subacute stage. Methods:From October 20, 2018 to February 1, 2020, 22 patients with first-onset subcortical ischemic stroke completed the assessments of MRI and clinical evaluation at admission, and after one and two months of rehabilitation. Cortical surface area, thickness, and volume were measured to evaluate cortical structure plasticity. Two-way repeated measures analyses of variance were implemented to estimate dynamic cortical morphology changes and differences between hemispheres. Results:A significant time effect occurred between admission and after one month of rehabilitation for both hemispheres. Cortical surface area, thickness and volume for most regions in both hemispheres gradually decreased, while parahippocampal gyrus thickness and volume increased. The surface area and volume of postcentral gyrus was significant between both hemispheres (F > 4.305, P < 0.05), in which ipsilesional hemisphere was lower than contralesional hemisphere. The reduction of the thickness (r = -0.474, P = 0.026) and volume (r = -0.432, P = 0.044) of postcentral gyrus in ipsilesional hemisphere was negatively correlated with the recovery rate of motor function. Conclusion:There are differences in cortical structure plasticity during stroke rehabilitation between hemispheres. Cortical morphology markedly changes in the first two months poststroke. The greater the reduction in thickness and volume of postcentral gyrus in ipsilesional hemisphere is, the worse the recovery of motor function may be.

Intervención integral en el ictus / Comprehensive intervention in stroke

Introducción: se mantiene el debate sobre qué tipos de intervenciones para la recuperación del ictus ofrecen mejores resultados para el paciente. Objetivo: evaluar el efecto de una intervención integral durante seis meses sobre la recuperación funcional en pacientes con ictus. Métodos: la muestra estuvo compuesta por 42 participantes con ictus: un grupo experimental (N = 22) con una media de edad de 52,68 años (DE = 14,39) que recibió una intervención integral, intensiva y multidisciplinar, y un grupo control (N = 20) con una media de edad de 56,20 años (DE = 14,82) que no recibió este tipo de intervención. Se valoraron los siguiente índices de severidad del ictus: Escala de Coma de Glasgow, Escala Canadiense, estancia en Unidad de Cuidados Intensivos, signos de enclavamiento uncal, signos de hipertensión endocraneal, volumen del hematoma/área isquémica, desplazamiento de línea media, necesidad de cirugía y tiempo total de hospitalización. Ambos grupos eran equivalentes en estos índices de gravedad. El grado de funcionalidad fue medido con la aplicación de la escala Functional Independence Measure and Functional Assessment Measure. Esta prueba se aplicó al inicio de la intervención y 6 meses después. Resultados: se observó una evolución positiva en ambos grupos en todas las áreas de la escala. La intervención integral y un menor tiempo total de hospitalización se relacionaron con una mejor recuperación funcional en el ictus. Conclusiones: se sugiere la necesidad de realizar estrategias de rehabilitación integral en los pacientes con ictus(AU)

Introduction: debate is currently underway about what types of stroke recovery interventions are more beneficial for patients. Objective: evaluate the effect of a six-month comprehensive intervention on the functional recovery of stroke patients. Methods: the study sample was 42 stroke patients: an experimental group (N = 22), mean age 52.68 years (SD = 14.39), who received a comprehensive intensive multidisciplinary intervention, and a control group (N = 20), mean age 56.20 years (SD = 14.82), who did not receive this type of intervention. The following stroke severity indices were applied: Glasgow Coma Scale, Canadian Scale, intensive care unit stay, uncal latching signs, endocranial hypertension signs, hematoma volume / ischemic area, midline displacement, need for surgery and total hospital stay time. These severity indices were similar in the two groups. Degree of functionality was gauged with the scales Functional Independence Measure and Functional Assessment Measure. This test was applied at the start of the intervention and 6 months later. Results: both groups had a positive evolution in all the areas of the scale. The comprehensive intervention and a shorter total hospital stay were associated to better functional recovery from stroke. Conclusions: the need is suggested to implement comprehensive rehabilitation strategies in stroke patients(AU)

Modulation of Electrophysiology by Transcranial Direct Current Stimulation in Psychiatric Disorders: A Systematic Review

OBJECTIVE: Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique increasingly used to relieve symptoms of psychiatric disorders. Electrophysiologic markers, such as electroencephalography (EEG) and event-related potentials (ERP), have high temporal resolution sensitive to detect plastic changes of the brain associated with symptomatic improvement following tDCS application. METHODS: We performed systematic review to identify electrophysiological markers that reflect tDCS effects on plastic brain changes in psychiatric disorders. A total of 638 studies were identified by searching PubMed, Embase, psychINFPO. Of these, 21 full-text articles were assessed eligible and included in the review. RESULTS: Although the reviewed studies were heterogeneous in their choices of tDCS protocols, targeted electrophysiological markers, and disease entities, their results strongly support EEG/ERPs to sensitively reflect plastic brain changes and the associated symptomatic improvement following tDCS. CONCLUSION: EEG/ERPs may serve a potent tool in revealing the mechanisms underlying psychiatric symptoms, as well as in localizing the brain area targeted for stimulation. Future studies in each disease entities employing consistent tDCS protocols and electrophysiological markers would be necessary in order to substantiate and further elaborate the findings of studies included in the present systematic review.

Progress of Researches on Mechanisms of Acupuncture Therapy in Regulating Brain Plasticity / 针刺研究

Brain plasticity is referred to the ability of the brain to change in structure and functional activities from microscopic aspects (synapses) in individual neurons to larger-scale aspects such as cortical remapping, neuronal remodeling, etc. in response to injury. Acupuncture has a positive effect in the treatment of cerebral diseases, thus leading to an increasing research on its underlying mechanisms in regulating brain plasticity. The present paper reviewed recent development of studies on acupuncture treatment of Alzheimer's disease, vascular dementia, cerebral ischemia, bone cancer pain, autism, etc. from 1) regulating synaptic plasticity (up-regulating the proportion of hippocampal synapses, increasing synaptic curvature, post-synaptic density, and numerical density, areal density, and lowering synaptic cleft); 2) increasing hippocampal post-synaptic potential slop, peak and peak area of population spikes to evoke long-term potentiation (LTP) by regulating the expression of glutamate N-methyl-D-aspartate (NMDA) and alpha amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors, and growth associated protein (GAP-43); 3) down-regulating the expression of glial fibrillary acidic protein (GFAP) to suppress the activity of astrocytes in the ischemic cerebral area and hippocampus in cerebral ischemia rats, and in the spinal cord dorsal horns of bone cancer rats, etc. and promoting vimentin and connexin 43 expression; and 4) promoting neuronal remodeling, and repair and regeneration of the injured nerve in the central nervous system via regulating neuron-glia network, expression of nerve growth factor, brain derived neurotrophic factor, etc. The future studies should pay more attention to 1) the contribution of acupuncture intervention to the correlation between the initiation of the endogenous protective effect and the brain plasticity during the onset of nerve injury and repair of the injured nerve, and 2) standarization of stimulating quantity, manipulation and duration of acupuncture treatment, as well as the relationship between the stimulating quantity and efficacy.

The impact of flat deformity of the cerebral cortex on motor functioning and cognition / 中华物理医学与康复杂志

Objective To investigate the impact flat deformity of the cerebral cortex induced by congenital hydrocephalus on motor functioning and cognition.Methods Tomography was used to confirm the presence of flat cortex deformity in three congenital hydrocephalus patients ranging in age from 20 to 33.Their motor control,balance,cognition and ability in the activities of daily living (ADL) were evaluated using the Fugl-Meyer assessment (FMA),the Berg balance scale (BBS),the mini-mental state examination (MMSE) and the modified Barthel index (MBI).Speech dysfunction was judged on the basis of clinical communication.The patients were scanned using a 64-slice spiral CT and size-of-ventricle indices were calculated.Results All 3 patients underwent ventrideperitoneal shunt.Their FMA scores were 75.5,83 and 100,with BBS scores of 4,24 and 56,MMSE scores of 14,23 and 26,and the MBIs of 40,90 and 100.CT images showed obvious ventricle enlargement and a thinner cortex layer in all three,with the thinnest part 0.18 cm,0.22 cm and 0.57 cm.Their ventricle indexes were 303％,288％ and 192％,respectively.Conclusion Although there is no systematic rehabilitation therapy for such patients,their motor,cognition and speech functioning were good,indicating the great potential for plasticity of the human brain.

Brain plasticity of structural and functional in elderly with subjective memory complaints / 中华行为医学与脑科学杂志

Subjective memory complaints (SMC) is increasingly recognized as the earliest prodromal stage of Alzheimer's disease.Individuals with SMC whose memory without measurable cognitive deficits,however,demonstrated some neurodegenerative brain changes.It would be more appropriate to prevent or postpone the AD process by interventing in this earlier stage of SMC,while relatively little is known about the brain plasticity in elderly with SMC.Therefore,further research is necessary in understanding the brain plasticity in SMC on the basis of further elucidating the pathophysiological mechanisms in this group of individuals.

Objective Predictors of Functional Recovery Associated with Intercostal Nerves Transfer for Triceps Reinnervation in Global Brachial Plexus Palsy

Objective To evaluate the predictors of functional recovery associated with the transfer of intercostal nerves (ICNs) to the branch innervating the long head of the triceps (BLHT). Methods A retrospective analysis of 14 patients with global brachial plexus palsy for whom the surgical planning included the transfer of 2 or 3 ICNs to the BLHT. Results The effective rate of functional recovery for elbow extension was 28%. Surgical timing, severity of the injury, and number of ICNs did not show significance for functional recovery. Patients who underwent ICN transfer for reanimation of elbow extension in combination with phrenic nerve (PN) transfer for reinnervation of elbow flexion, or shoulder stability, obtained poorer results regarding triceps recovery (p < 0.01). Conclusions Intercostal nerves are reliable donors for reinnervation of the triceps in global brachial plexus injuries. However, this technique should be avoided in patients in whom the PN has been transferred for elbow flexion or shoulder abduction.

Objetivos Avaliar os fatores preditores para recuperação funcional associados à transferência de nervos intercostais (NICs) para o ramo do nervo radial que inerva da cabeça longa do tríceps (RCLT). Métodos Análise retrospectiva de 14 pacientes com paralisia completa do plexo braquial, para os quais o planejamento cirúrgico incluiu a transferência de 2 ou 3 NICs para o RCLT. Resultados A taxa de recuperação da extensão do cotovelo foi de 28%. O intervalo cirúrgico, a gravidade da lesão e o número de NICs usados não demonstraram significância para a recuperação funcional. Os pacientes nos quais a transferência de NIC foi usada para recuperação da extensão do cotovelo concomitantemente à transferência do nervo frênico para reanimação da flexão do cotovelo ou para estabilização do ombro obtiveram piores resultados quanto a reinervação do tríceps (p < 0.01). Conclusões Os NICs podem ser utilizados como doadores para reinervação do tríceps em lesões completas do plexo braquial. No entanto, essa técnica deve ser evitada em pacientes nos quais o nervo frênico foi transferido conjuntamente visando a recuperação da flexão do cotovelo ou a estabilização do ombro.

Brain Plasticity and Neurorestoration by Environmental Enrichment

In the adult mammalian brain, neural-lineage cells are continuously generated in the subventricular zone (SVZ) and dentate gyrus of the hippocampus. These cells in vivo arising from the adult SVZ may be regulated by environmental enrichment (EE). EE is a method of raising animals in a huge cage containing novel objects, running wheels and social interaction with a complex combination of physical, cognitive, and social stimulations. EE can affect neural plasticity via overexpression of growth factors such as brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1), fibroblast growth factor-2 (FGF-2), and synaptic activity-regulating genes. EE also have advanced effects on brain functions including the enhancement of motor and cognitive functions in normal and pathological states. Additionally, behavioral changes by EE are related with molecular changes including neurogenesis, gliogenesis, angiogenesis, axonal sprouting, and dendritic branching in the adult brain. In this review, we focus on brain plasticity and neurorestoration associated with molecular changes of neurotrophic growth factors such as BDNF, VEGF, IGF-1, FGF-2 and synaptic activity-regulating genes that occurs in interaction to EE.

Brain Plasticity of Upper Extremity Motor Function Recovery after Stroke: A Diffusion Tensor Imaging Study / 中国康复理论与实践

@#Objective To explore brain plasticity of upper extremities motor function recovery after stroke with diffusion tensor imaging (DTI). Methods 25 stroke patients with internal capsule lesions and affected corticospinal tract (CST), 4-8 weeks after onset, were divided randomly into rehabilitation group (n=13) and control group (n=12). Both groups received routine medication and the rehabilitation group also received rehabilitation. All the patients were scanned with DTI and assessed with upper extremity Fugl-Myer Assessment (UE-FMA) before and 3 months after treatment. The fractional anisotropy (FA), FA ratio (rFA) and FA asymmetry (FAasy) in cerebral peduncle, posterior limb of internal capsule (PLIC) and corona radiate were obtained. The bilateral corticospinal tracts were reconstructed with diffusion tensor tractography. Results The scores of UE-FMA increased in both groups after treatment (P<0.05), and increased more in the rehabilitation group than in the control group (P<0.05). There was significant difference in FA, rFA and FAasy in the corona radiate section of CST after treatment in the rehabilitation group (P<0.05), but was not in the cerebral peduncle and PLIC section. However, there was no significant differences in FA, rFA and FAasy in the control group. The ipsilesional CST fibers were more compact after treatment in the rehabilitation group. Conclusion Rehabilitation can improve the upper extremities function recovery after stroke, which may associated with the repairment of CST in the corona radiate section.

Brain Plasticity of Upper Extremity Motor Function Recovery after Stroke:A Diffusion Tensor Imaging Study / 中国康复理论与实践

Objective To explore brain plasticity of upper extremities motor function recovery after stroke with diffusion tensor imaging (DTI). Methods 25 stroke patients with internal capsule lesions and affected corticospinal tract (CST), 4-8 weeks after onset, were divided randomly into rehabilitation group (n=13) and control group (n=12). Both groups received routine medication and the rehabilitation group al-so received rehabilitation. All the patients were scanned with DTI and assessed with upper extremity Fugl-Myer Assessment (UE-FMA) be-fore and 3 months after treatment. The fractional anisotropy (FA), FA ratio (rFA) and FA asymmetry (FAasy) in cerebral peduncle, posterior limb of internal capsule (PLIC) and corona radiate were obtained. The bilateral corticospinal tracts were reconstructed with diffusion tensor tractography. Results The scores of UE-FMA increased in both groups after treatment (P<0.05), and increased more in the rehabilitation group than in the control group (P<0.05). There was significant difference in FA, rFA and FAasy in the corona radiate section of CST after treatment in the rehabilitation group (P<0.05), but was not in the cerebral peduncle and PLIC section. However, there was no significant dif-ferences in FA, rFA and FAasy in the control group. The ipsilesional CST fibers were more compact after treatment in the rehabilitation group. Conclusion Rehabilitation can improve the upper extremities function recovery after stroke, which may associated with the repair-ment of CST in the corona radiate section.

Neurorehabilitation of Stroke / The Japanese Journal of Rehabilitation Medicine

Despite recent advances in acute stroke management, many stroke patients suffer from long-term disability. Most stroke patients regain their function partially or fully during the first 3 to 6 months depending on many factors ; pre-stroke, stroke and post-stroke factors. Brain plasticity plays a major role during stroke recovery, and motor-relearning and brain plasticity shares the common mechanism. Successful neurorehabilitation is to drive beneficial plastic change and therefore to gain functional recovery. In this brief review, we will discuss mechanisms of brain plasticity engaged in stroke recovery and recent advanced management strategies for stroke recovery.

Bases Neurobiológicas de la Rehabilitación / Neurobiological Basis of Rehabilitation

Los tratamientos de rehabilitación neurológica se fundamentan en una propiedad intrínseca del Sistema Nervioso Central: la de adaptarse a los cambios en su entorno. La Plasticidad Cerebral involucra modificaciones estructurales y funcionales en las neuronas y en las redes neuronales y para su comprensión es necesario contemplar lo que sucede en diferentes niveles, considerando asimismo los factores genéticos y no genéticos que pueden influir en estos procesos. En la actualidad existen técnicas electrofisiológicas y por imágenes que permiten el estudio de la Plasticidad Cerebral en los seres humanos sanos y con lesiones cerebrales. Una mayor comprensión de los fenómenos que ocurren en el Sistema Nervioso luego de una lesión puede posibilitar la aplicación de intervenciones terapéuticas adaptadas a las necesidades de cada individuo.

Neurological rehabilitation treatments are based on an intrinsic property of the Central Nervous System: to adapt to changes in their environment. Cerebral Plasticity involves structural and functional changes in neurons and neural networks and to their understanding is necessary to consider what happens at different levels, considering also genetic and non-genetic factors that may influence these processes. There are currently electrophysiological and images that allow the study of Brain Plasticity in healthy humans and with brain injuries. Greater understanding the phenomena that occur in the nervous system after an injury may enable therapeutic application tailored to the needs of each individual.

Feedback and neuroplasticity rehabilitation for brain damage / 中华物理医学与康复杂志

Neuroplasticity,also known as brain plasticity,refers to the brain tissue's ability to be repaired to reorganized and to create new connections among the nerve cells.It implies that the location of a given function in the brain (for example,certain area in the motor cortex) can displace to another area of the cortex.This transfer ability can be accomplished by sensory motor feedback training.In the case of cerebral palsy (CP) and stroke,neuroplasticity relates to unaffected nerve cells and new synaptogenesis process taking over the functions of damaged nerve cells and their connections.The aim of this overview is to explain how does neuroplasticity work and how intensive sensory motor feedback training can reorganize nerve cells.Although neurorehabilitation offers a series of therapies from the psychological to occupational,speech,teaching or re-training patients on mobility skills,this overview focuses on physical rehabilitation using a comprehensive feedback system to accelerate brain recovery.

Renovación sináptica y evolución: el eje de la plasticidad cerebral / Synaptic renewal and evolution: the axis of brain plasticity

El famoso Psicólogo estadounidense William James, fue el primero en hablar de plasticidad hacia el año de 1890, para describir la modificación de las redes neuronales. Autores como Santiago Ramon y Cajal, Arenander, de Vellis, Clark C. Speidel, entre otros aportaron igualmente al estudio de la sinaptogénesis, su evolución y su renovación; gracias a ellos se ha podido dar cabida y ampliación, a este fenómeno de supervivencia del cerebro. El estudio de la neuroplasticidad constituye uno de los aportes más importantes, que se está dando a la educación en los últimos tiempos. Se trata de una capacidad del cerebro, que le permite aumentar o disminuir el número de ramificaciones neuronales y de sinapsis, a partir del estímulo sobre el córtex cerebral (Acharya, Shukla, Mahajan & Diwan, 2012). Así es como se comprende que la neuroplasticidad sea la base estructural del aprendizaje, porque existe una estrecha relación entre estímulos internos y externos recibidos, y el proceso de transformación del cerebro a lo largo de toda la vida

The famous American psychologist William James, was the first to speak of plasticity around the year 1890, to describe the modification of neural networks. Authors such as Santiago Ramon y Cajal, Arenander, de Vellis, Clark C. Speidel, among others also contributed to the study of synaptogenesis, its evolution and its renewal; thanks to them it has been possible to accommodate and expand this phenomenon of brain survival. The study of neuroplasticity constitutes one of the most important contributions, which is being given to education in recent times. It is a capacity of the brain, which allows it to increase or decrease the number of neuronal branches and synapses, based on the stimulus on the cerebral cortex (Acharya, Shukla, Mahajan & Diwan, 2012). This is how it is understood that neuroplasticity is the structural basis of learning, because there is a close relationship between internal and external stimuli received, and the process of transformation of the brain throughout life

Effect of the Presence of Brain-Derived Neurotrophic Factor Val66Met Polymorphism on the Recovery in Patients With Acute Subcortical Stroke

OBJECTIVE: To investigate the effect of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism on the recovery after subcortical stroke, using the modified Rankin Scale (mRS). METHODS: Subcortical stroke patients with copies of BDNF Val66Met polymorphism (n=7) were compared to their controls (n=7) without a copy of BDNF Val66Met polymorphism after matching for initial severity, location and type of stroke. The mRS scores at 1 and 3 months after discharge from the neurorehabilitation unit were compared between the groups. RESULTS: A repeated measures ANOVA for mRS revealed significant interaction between time and group (F(2, 24) =37.2, p<0.001) and a significant effect of time (F(2, 24)=10.8, p<0.001), thereby reflecting significant differences between the Met allele (+) group and the Met allele (-) group. There was a significant difference in mRS scores at 3 months post-discharge between the two groups (p=0.01) although no difference was evident in mRS scores at 1 month post-discharge between the two groups. There were significant improvements between mRS scores on admission and mRS scores at 1 month post-discharge (p=0.02), and between mRS scores at 1 month post-discharge and mRS scores at 3 months post-discharge (p=0.004) in the Met allele (-) group. CONCLUSION: BDNF Val66Met polymorphism may be associated with worse functional outcome in Korean patients with subcortical stroke. Therefore, BDNF Val66Met polymorphism should be considered as an important prognostic factor for recovery and responses to rehabilitation therapies after stroke in Korean patients. There is a need for developing different rehabilitation strategies for the population with BDNF Val66Met polymorphism. Further studies assessing different outcomes for various functional domains of stroke recovery are needed to clarify the role of BDNF Val66Met polymorphism.

Maternal separation during breastfeeding induces changes in the number of cells immunolabeled to GFAP

The mother-child relationship is fundamental to the establishment and maintenance of synaptic networks and physiological and emotional development. Animal models including maternal separation have been used to study changes at behavioral and neurobiochemical levels. Due to the relevance of glial cells during development, our aim was to determine if short periods of maternal separation during breastfeeding induce permanent changes in a number of astrocytes labeled with the glial fibrillary acidic protein in different brain areas. Wistar rats were housed under standard laboratory conditions with reversed light/dark cycle; food and water ad libitum. Pups were separated from their mothers for 6 h daily during breastfeeding period. On day 22, pups were separately housed according to gender and treatment. At day 60, subjects were evaluated in the elevated plus maze and, after processing for immunohistochemistry, 20-μm sections were made. Prefrontal cortex, paraventricular nucleus, preoptic area, hippocampus and amygdala were localized. Labeled cells were quantified using Image-J program. Results showed that separated females had more entries into open arms and spend more time as compared with the control groups. In the prefrontal cortex we identified a decrease in staining cells in separated females, whereas there was an increase in staining cells in separated males. In the hippocampus and preoptic area, we observed a decrease only in separated males. We did not find any differences in the paraventricular nucleus or amygdala. Our results indicate that maternal separation during breastfeeding induces permanent changes in the number of astrocytes in different brain areas of both males and females.

Functional Reorganization Associated with Semantic Language Processing in Temporal Lobe Epilepsy Patients after Anterior Temporal Lobectomy : A Longitudinal Functional Magnetic Resonance Image Study

OBJECTIVE: The focus of this study is brain plasticity associated with semantic aspects of language function in patients with medial temporal lobe epilepsy (mTLE). METHODS: Using longitudinal functional magnetic resonance imaging (fMRI), patterns of brain activation were observed in twelve left and seven right unilateral mTLE patients during a word-generation task relative to a pseudo-word reading task before and after anterior temporal section surgery. RESULTS: No differences were observed in precentral activations in patients relative to normal controls (n = 12), and surgery did not alter the phonological-associated activations. The two mTLE patient groups showed left inferior prefrontal activations associated with semantic processing (word-generation > pseudo-word reading), as did control subjects. The amount of semantic-associated activation in the left inferior prefrontal region was negatively correlated with epilepsy duration in both patient groups. Following temporal resection, semantic-specific activations in inferior prefrontal region became more bilateral in left mTLE patients, but more left-lateralized in right mTLE patients. The longer the duration of epilepsy in the patients, the larger the increase in the left inferior prefrontal semantic-associated activation after surgery in both patient groups. Semantic activation of the intact hippocampus, which had been negatively correlated with seizure frequency, normalized after the epileptic side was removed. CONCLUSION: These results indicate alternation of semantic language network related to recruitment of left inferior prefrontal cortex and functional recovery of the hippocampus contralateral to the epileptogenic side, suggesting an intra- and inter-hemispheric reorganization following surgery.

Brain Plasticity in Aphasia

Dominant hemisphere for language function is the left hemisphere, however patients experiencing aphasia followed by damage to language areas often shows good recovery in the days to weeks to even years after brain injury. According to the duration from brain injury, recovery period of language function in aphasia can be divided into three overlapping periods (acute, subacute, and chronic phase) with different underlying neural mechanisms. During subacute period of weeks to months following brain injury, reorganization of neural network through brain plasticity occurring in the both hemisphere plays a crucial role in recovery of language function. Recently, the potential use of functional neuroimaging has been raised to explain the underlying neural mechanism for language recovery, however, the brain areas and various factors affecting brain reorganization are still controversial. This article reviews the clinical evidence for recovery of language function through brain plasticity and reorganization and the factors affecting the recovery of language function in aphasic patients following brain injury.