Estudo da remodelação dos mapas motores corticais após o acidente vascular encefálico isquêmico: efeito da reabilitação combinada baseada no enriquecimento ambiental e (re)aprendizagem motora
Over the past decades, Brazilian population over 60 years of age has increased, as well as chronic diseases related to aging. Among these, stroke, one of the main causes of hospitalizations and mortality in Brazil; causing some type of disability to perform activities of daily living to the major...
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| Formato: | doctoralThesis |
| Idioma: | pt_BR |
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Brasil
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| Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/26953 |
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| Resumo: | Over the past decades, Brazilian population over 60 years of age has increased, as
well as chronic diseases related to aging. Among these, stroke, one of the main causes
of hospitalizations and mortality in Brazil; causing some type of disability to perform
activities of daily living to the majority of patients. Understanding how the rehabilitation
process occurs, such as the remodeling of motor maps and motor pathways is of
utmost importance. The study of this phenomenon can lead to optimization of
rehabilitation and to a better understanding of how drugs can act to restore brain
function following stroke. In addition, lesion location and severity are determinant for
the level of motor impairment following the insult. Preliminary results obtained by PhD
Numa Dancause and PhD Dale Corbett research teams indicated that when the lesion
encompass the dorsal striatum, motor representations are extremely impaired.
Therefore, it was hypothesized that the dorsal striatum has a determining role in the
constitution and possible remodeling of the cortical maps during motor relearning. In
addition, subcortical structures may increase activity and assume a more active role in
the expression of motor behavior. In this thesis we develop a new methodology to
quantify and better understand changes of upper limb movement following stroke in
rodents (rats: Article 1; mice: Article 2). Next, we review the main pathways and
mechanisms involved in motor relearning following stroke (Article 3). Finally, the main
article of this thesis demonstrates how intensive rehabilitation promotes cortical motor
map plasticity (Article 4). Intensive rehabilitation led to motor map expansion,
increased kinematic movement of the paretic limb, and increased use-dependent
activity of compensatory brain regions, such as the contralesional cortex and red
nucleus. Here, we propose an intertwined mechanism for severe stroke recovery,
which involves bilateral and bi-hemispheric interactions. In short, this thesis
corroborates that rehabilitation promotes expansion of cortical motor representations;
and advances the knowledge about compensatory recovery following severe stroke in
rats. |
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