影响皮质可塑性因素的研究

虽然在上世纪 3 0年代BetheA即提出脑的可塑性理论 ,但在 15 -3 0年前 ,学术界的普遍观点还是脑的功能损伤是不能恢复、再生和修复的。目前 ,脑的可塑性当今己为许多现代化手段 (PET、fMRI、TMS等 )和临床实验所证实。脑的功能恢复 ,即脑的功能重组和可塑性 ,在脑血管病和外伤性脑损伤中研究得最多。现就影响可塑性的因素 ,如年龄、神经营养因子、神经干细胞神经移植、神经调节剂、激素、环境与药物干预等介绍如下。1年龄年龄对脑损伤的恢复有影响 ,即所谓“Kennard”原理 :脑在生命早期受到伤害与成熟个体同样伤害相比 ,损伤要少得多[…     

中枢神经系统（CNS）损伤后功能恢复的理论（四）

本节介绍伤后早期有利于功能恢复的因素之一──自发恢复的内部因素。     

评价脑功能和脑的可塑性的综合技术

脑的可塑性研究显示,无论健康状态还是损伤以后,无论儿童、成人还是老年人,脑在外界环境输入影响下均有很强的可塑性。了解和评价其可塑性机制是寻求高效治疗措施、促进恢复的重要基础。现回顾CNS可塑性机制以及评价脑功能和脑可塑性的无创的综合技术。     

功能神经影像学技术:研究人脑可塑性的有效工具

神经科学和康复医学研究者在长期的临床实践中,发现在脑损伤后,功能是有可能或有条件恢复的。1930年,神经康复学家提出脑的可塑性理论,认为脑可以通过学习和训练完成因病损而丧失的功能,但大脑必须具有重新获得功能的形态学基础。1938年Kennard进一步提出脑功能重组理论,认为在脑损伤后,大脑在结构与功能上可以通过重组来承担已经失去的功能。实验证明,经过训练和改变外界环境,通过邻近或对侧组织的代偿、失神经过敏、轴突侧支长芽、潜伏通路和突触的启用、行为代偿等可使功能得到恢复,这些都是功能重组的结果。脑的可塑性(brainplasticity…     

运动疗法对脑功能重塑影响的分子机制研究进展

脑的可塑性是指中枢神经系统(central nervous system,CNS)的形态结构和功能活动在适应机体内外环境变化时的可修饰性[1].由于CNS在结构上的脆弱性和功能上的复杂性,其损伤往往造成严重的功能障碍,影响患者的生存质量.自1930年Bethe提出脑的可塑性理论以来,脑的可塑性理论作为脑损伤后机体功能恢复机制研究的一个重要方向,一直是人们关注的热点.在长期以来的临床实践中,运动疗法作为一种简单易行的治疗脑损伤的方法,已被普遍应用于临床.适宜的运动训练不但能够提高患者的运动功能,而且对学习、记忆能力也有明显改善,且疗效肯定.     

脑室旁白质软化症患儿脑性视觉损伤及其可塑性的功能磁共振研究现状与进展

脑室旁白质软化症(PVL)是导致脑瘫的重要因素之一,其中视觉障碍即所谓的脑性视觉损伤是PVL常见且重要的合并损伤,对患儿早期智力发育及日后认知水平均有不良影响,而早期进行视觉功能及其可塑性评价对临床制定合理、有效的治疗方案和康复措施具有重要的指导意义。现就PVL患儿脑性视觉损伤及其可塑性的功能影像学研究现状和进展综述如下。     

脑室旁白质软化症患儿脑性视觉损伤及其可塑性的功能磁共振研究现状与进展

脑室旁白质软化症(PVL)是导致脑瘫的重要因素之一,其中视觉障碍即所谓的脑性视觉损伤是PVL常见且重要的合并损伤,对患儿早期智力发育及日后认知水平均有不良影响,而早期进行视觉功能及其可塑性评价对临床制定合理、有效的治疗方案和康复措施具有重要的指导意义。现就PVL患儿脑性视觉损伤及其可塑性的功能影像学研究现状和进展综述如下。     

中枢性神经损伤康复治疗理论与方法

康复医学是一门理论与技术紧密结合的专业学科。在临床实践中将神经发育学、神经生理学、脑可塑性和功能重组等有关理论有针对性地运用到中枢性神经（CNS）损伤的功能恢复训练中形成了专门的实用技术。     

损伤脑功能重建的基础研究进展

自从1930年Bethe提出脑具有可塑性~([1]),即中枢神经的结构和功能具有随着内外环境变化而不断修饰和重组的能力~([2]),脑功能重建逐渐成为神经损伤康复研究的热点.脑的可塑性不仅体现在神经元自身修复及神经网络的重组上,更是微环境相关细胞、分子,甚至基因调节的综合结果.     

功能性近红外光谱成像技术在脑卒中运动功能障碍康复中的应用进展

功能性近红外光谱成像技术(fNIRS)是一种非侵入性脑成像技术, 可用于评估脑卒中运动功能障碍患者的皮质激活情况和功能连接水平等。观察不同神经康复治疗方法对脑卒中运动功能障碍患者大脑皮质激活的影响, 可以为评定神经功能损伤程度和神经可塑性变化提供依据, 有利于个体化、精准化康复。     

功能磁共振成像在脑损伤康复期演变中的应用

脑损伤患者在康复过程中会伴有不同程度的脑组织重塑和功能重组.功能磁共振成像(fMRI)能够获得脑组织的解剖学、生理学及病理学信息,并且在一定程度上反映各功能区间的相互联系.因此.fMRI技术能够反映脑损伤康复过程中脑组织发生的结构和功能变化,为临床开展有针对性的治疗提供有价值的信息.     

丰富康复训练与神经可塑性

神经可塑性是指神经系统对外界环境刺激可做出适应性改变的特性。神经可塑性的理论研究最早开始于脑卒中后的功能恢复。脑卒中后的运动功能恢复主要出现在数周或数月内,通常归因于脑神经的可塑性。已证实将丰富环境和一般康复训练相结合的丰富康复训练可以使大脑达到最佳的功能恢复。如何掌握丰富康复训练的时机和持续时间是当前研究的热点。     

Diffusion and perfusion-weighted magnetic resonance imaging techniques in stroke recovery

Most of the functional recovery after stroke takes place during the first three months after the insult. The neuronal mechanisms underlying this recovery are presently mostly unknown. However, in order to create efficient rehabilitation programs, it is of great importance to uncover these mechanisms. Multiple imaging techniques have been employed for the detection and characterization of ischemic lesions in the brain as well as monitoring of processes associated with stroke recovery. Diffusion and perfusion-weighted magnetic resonance imaging techniques are easy and fast to perform and provide significant information about the ischemic lesion and the hypoperfusion surrounding the lesion at both micro and macrovascular level. More sensitive detection and accurate characterization of the lesion will help in choosing the therapeutic strategies. Methods for monitoring brain function recovery will provide a better understanding of the basic mechanisms of plasticity in the brain, and will serve as a tool for the evaluation of therapeutic interventions, which may eventually include, for example, stem cell transplantation. With the help of these diagnostic tools it may become possible to tailor individual rehabilitation programs.     

脑损伤后功能恢复机制的研究进展

随着各种原因所致的脑损伤发病率的上升,脑损伤后的功能恢复已成为多学科研究关注的焦点。本文以脑的可塑性学说为基础,从神经细胞的改变、功能重组、功能替代、大脑皮层兴奋性改变和特殊技巧学习等几个方面,对脑损伤后的功能恢复机制进行阐述。     

Plasticity in neurological disorders and challenges for noninvasive brain stimulation (NBS)

There has been considerable interest in trialing NBS in a range of neurological conditions, and in parallel the range of NBS techniques available continues to expand. Underpinning this is the idea that NBS modulates neuroplasticity and that plasticity is an important contributor to functional recovery after brain injury and to the pathophysiology of neurological disorders. However while the evidence for neuroplasticity and its varied mechanisms is strong, the relationship to functional outcome is less clear and the clinical indications remain to be determined. To be maximally effective, the application of NBS techniques will need to be refined to take into account the diversity of neurological symptoms, the fundamental differences between acute, longstanding and chronic progressive disease processes, and the differential part played by functional and dysfunctional plasticity in diseases of the brain and spinal cord.     

中枢神经系统(CNS)损伤后功能恢复的理论(八)

本节除继续介绍后期及晚期促进功能恢复的内部因素外,同时介绍外部的因素。     

脊髓损伤后脑功能区重塑的功能磁共振研究进展

脊髓损伤后可引起大脑解剖结构和功能区的变化,其中功能可塑性变化对患者的预后起着重要作用.fMRI可无创、直观地显示脑区活动,目前已成为评估大脑功能变化的重要手段.本文对脊髓损伤后脑功能可塑性变化的fMRI研究进行综述.     

中枢神经系统(CNS)损伤后功能恢复的理论(七)

本节除继续介绍功能恢复的外界影响外,同时介绍后期及晚期促进功能恢复的内部因素。     

The life history of brain dopamine

Neurochemical studies in Parkinson's disease have greatly contributed to the understanding of the neurobiology of the meso-telencephalic dopamine (DA) system; in addition, these studies have significantly influenced our concepts regarding the general principles of brain function. The primary role of DA in striatal function can be seen in its ability to initiate complex patterns of motor activity. The nigro-striatal DA system shows in the face of partial damage an extraordinarily high degree of plasticity, i.e. capacity for functional compensation. The two most important mechanisms of plasticity of the nigro-striatal DA system are: compensatory activation of the presynaptic remaining DA neurons (through increase in DA turnover); and increase in the number of postsynaptic DA receptors. The DA loss which occurs during normal ageing is not of sufficient magnitude to cause clinically overt Parkinson's disease. On the other hand, the observations pertaining to the Parkinsonian syndrome produced by NMPTP suggest the participation of environmental factors in the aetiology of idiopathic Parkinson's disease. The remarkable results of nigral cell transplants into the striatum of animals with experimental "parkinsonism", as well as the high therapeutic efficacy of DA substitution in patients with Parkinson's disease point toward a neurohumoral, rather than neurotransmitter, function of brain DA.     

Ethanol and brain plasticity: receptors and molecular networks of the postsynaptic density as targets of ethanol

Brain plasticity refers to the ability of the brain to undergo structural and functional changes. It is a necessary process that allows us to adapt and learn from our environment and is fundamental to our survival. However, under certain conditions, these neuroadaptive responses can have adverse consequences. In particular, increasing evidence indicates that plastic processes are coopted by drugs of abuse, leading to addiction and associated drug-seeking behaviors. An extensive and diverse group of studies ranging from the molecular to the behavioral level has also strongly implicated glutamatergic neurotransmission as a critical mediator of experience-dependent synaptic plasticity. Thus, it is vital to understand how drugs of abuse interact and potentially alter glutamatergic neurotransmission and associated signal transduction processes. This review will focus on the cellular and molecular neuroscience of alcoholism, with emphasis on events at the glutamatergic postsynaptic density (PSD) and dendritic spine dynamics that appear to underlie much of the structural and functional plasticity of the CNS.