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Query: UMLS:C0599766 (functional recovery)
 13,441 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One possible mechanism for language plasticity in cases of lesions in left dominant hemisphere is the recruitment of homologous region in the unaffected non-dominant hemisphere. The potential of the right hemisphere to carry out such plasticity is expressed by the functional outcome of patients with lesions in the left hemisphere acquired at childhood prior to language acquisition. Whether lesions in the dominant hemisphere acquired in adulthood can result in functional recovery of language by means of recruitment of the non-dominant hemisphere is undetermined. We describe a 28-year-old, right-handed male diagnosed with a left temporo-frontal glioma. It was decided to manage him expectantly due to the low level of suspicion of malignancy and the close proximity of the lesion to critical language function centers. Language functional MRI (fMRI) tests were performed twice within the ensuing 2 years before surgical intervention. Regional brain activation was measured within the temporal and frontal lobes. Laterality index (LI) was calculated based on the corresponding number of activated voxels. The main finding is that over time, prior to resection of the enlarged tumor, the inferior frontal gyrus (IFG) changed from being strongly left lateralized in the first fMRI exam to being bilateral in the second fMRI exam, mainly due to larger activation in the right hemisphere. By that time, although the patient was not aphasic, his language performance was significantly below average. These findings suggest that a slow growing tumor in an adult language-related area might result in a functional reorganization by recruiting the right hemisphere. However, the contribution of such reorganization to the preservation of language performance remains equivocal.
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PMID:Language related reorganization in adult brain with slow growing glioma: fMRI prospective case-study. 1901 66

Intravenous transplantation of human mesenchymal stem cells (hMSCs) expanded from adult bone marrow ameliorates functional deficits in rat cerebral infarction models. Several hypotheses to account for the therapeutic mechanisms have been suggested, but angiogenesis is thought to be of critical importance. Recently, we have reported the therapeutic benefits of hMSCs which have been transfected with the angiopoietin-1 gene in a rat permanent middle cerebral artery occlusion (MCAO) model. To potentially enhance the therapeutic effects of angiopoietin-1 gene-modified hMSC (Ang-hMSC), we transfected hMSCs with the angiopoietin-1 gene and the VEGF gene, and investigated whether the combination of Ang-1 and VEGF gene-modified hMSCs (Ang-VEGF-hMSC) contribute to functional recovery in a rat MCAO model. We induced MCAO using intraluminal vascular occlusion, and hMSCs, Ang-hMSCs, VEGF-hMSCs or Ang-VEGF-hMSCs were intravenously infused 6 h later. MRI and behavioral analyses revealed that rats receiving Ang-VEGF-hMSCs showed the greatest structural-functional recovery as compared to the other groups. These results suggest that intravenous administration of hMSCs transfected with the angiopoietin-1 and VEGF gene using a fiber-mutant adenovirus vector may represent a new strategy for the treatment of ischemia.
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PMID:Therapeutic benefits of angiogenetic gene-modified human mesenchymal stem cells after cerebral ischemia. 1909 89

The afferent visual pathway is commonly affected in MS. Assessment of the afferent visual pathway using clinical, imaging and electrophysiological methods not only provides insights into the pathophysiology of MS, but also provides a method of investigating potential therapeutic measures in MS. This review summarises the various assessment methods, in particular imaging techniques of the visual pathway. Retinal nerve fibre layer (RNFL) thickness is usually reduced following an episode of optic neuritis. Techniques such as optical coherence tomography, scanning laser polarimetry, and confocal scanning laser ophthalmoscopy are used to quantify RNFL thickness. MRI of the optic nerve is not routinely used in the diagnosis of MS or optic neuritis, but is valuable in atypical cases and in research. T2- weighted images of the optic nerve usually show the hyperintense lesion in optic neuritis and gadolinium enhancement is seen in the acute attack. Quantifying atrophy of the optic nerve using MRI gives an indication of the degree of axonal loss. Magnetization transfer ratio (MTR) of the optic nerve provides an indication of myelination. Diffusion tensor imaging (DTI) of the optic nerve and optic radiation provide information about the integrity of the visual white matter tracts. Functional MRI following visual stimulation is used to assess the contribution of cortical reorganisation to functional recovery following optic neuritis. Investigations including logMAR visual acuity, Sloan contrast acuity, Farnsworth- Munsell 100-hue colour vision tests and Humphrey perimetry provide detailed quantitative information on different aspects of visual function. Visual evoked potentials identify conduction block or delay reflecting demyelination. These collective investigative methods have advanced knowledge of pathophysiological mechanisms in MS and optic neuritis. Relevant ongoing studies and future directions are discussed.
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PMID:Assessing structure and function of the afferent visual pathway in multiple sclerosis and associated optic neuritis. 1929 47

Recent experimental studies in rodents suggest that treatment with inhibitors of phosphodiesterase type 5 (PDE5) (tadalafil, sildenafil, zaprinast) not only increases cerebral blood flow but also improves functional recovery after stroke. Here, we investigated in a mouse model of stroke the effects of vardenafil on survival, functional outcome and lesion size after experimental stroke. Mice were subjected to experimental stroke by occlusion of the middle cerebral artery (MCAO) for 45 min. A group of mice received vardenafil (twice 10 mg/kg body weight per day orally over 14 days) starting 3 h after MCAO. Control animals received the vehicle only. Survival, body weight, and behavior were monitored over 4 weeks and brain lesions were measured by T2-weighted MRI, hematoxylin/eosin -- as well as GFAP-staining of cryostat sections, subsequently. The mortality in MCAO-operated animals amounted to 45% until day 10 after stroke and no significant difference in survival between the vardenafil- and vehicle-treatment groups was observed. Compared to sham-operated animals, MCAO-operated mice from both treatment groups demonstrated a significant weight loss until day 5 and regained their body weight by day 14 after ischemia. There was no significant difference between the vardenafil and vehicle-treated MCAO groups. In behavioral studies (sucrose consumption and pole test), analyzing sensorimotor functions as well as a parameter of depression-like symptoms, we observed no significant effect of vardenafil treatment on functional recovery in our model of stroke. Although we observed a trend towards less hemispherical atrophy in the vardenafil compared to the vehicle-treated group four weeks after MCAO our data do not suggest a functionally relevant CNS-tissue protective or regenerative effect in murine stroke.
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PMID:Effects of the PDE5-inhibitor vardenafil in a mouse stroke model. 1936 9

Large lesions produced by stroke to the forelimb region of motor cortex of the rat feature post-stroke improvement that in the main is due to compensation. The present study describes both recovery and compensation of forelimb use in a reach-to-eat (skilled reaching) task following small photothrombotic stroke. The rats were pretrained before stroke, and then assessed using endpoint measures and biometric movement analysis during rehabilitation in the acute and chronic post-stroke periods. Histological and MRI analysis indicated that the stroke consisted of a small lesion surrounded by cortex featuring scattered cell loss, likely of the large pyramidal cells that characterize the forelimb region of motor cortex. The stroke reduced reaching success, especially on the most demanding measure of success on first reach attempts, in the acute period, but with rehabilitation, performance returned to pre-stroke levels. Reach movements as assessed by biometric measures were severely impaired acutely but displayed significant recovery chronically although this recovery was not complete. The results suggest that not only do rats show post-stroke compensation in skilled reaching but they can also display functional recovery. It is suggested that recovery is mediated by the spared neurons in the peri-infarct region of forelimb motor cortex. The results demonstrate the utility of a small lesion model for studying post-stroke neural and behavioral change and support the view that optimal post-stroke treatment should be directed toward limiting tissue loss.
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PMID:Both compensation and recovery of skilled reaching following small photothrombotic stroke to motor cortex in the rat. 1940 94

The purpose of this study is to compare the therapeutic effects between autologous and allogenic bone-marrow-derived mesenchymal stem cell (MSC) transplantation in experimentally-induced spinal cord injury (SCI) of dogs. Thirty adult Beagle dogs (control group=10, autologous group=10, and allogenic group=10) were used in this study. Prelabeled MSCs were intrathecally transplanted through the lumbar spinal cord into the injured lesion at a density of 1 x 10(7) cells 7 days after SCI. Neurological signs of dogs in both autologous and allogenic groups were improved in their pelvic limbs after SCI compared with those in control group. Both autologous and allogenic groups showed significantly higher the Olby scores than control group (p<0.05). This finding was consistent with results of MRI and histopathological examination in both groups. Immunofluorescence analysis revealed that prelabeled autologous and allogenic MSCs were detected in the injured lesions both at 1 and 4 weeks after transplantation. However, the distribution ratio of MSCs on the injured lesion in allogenic group was significantly decreased at 4 weeks after transplantation relatively to at 1 week after transplantation. The mRNA expression for neurotrophic factors in both allogenic and autologous groups was significantly higher than that in control groups (p<0.05). Even though autologous MSC transplantation showed more beneficial effect than that of allogenic MSC transplantation, transplantation of allogenic MSCs also improved functional recovery following SCI. This study demonstrates that both autologous and allogenic MSC transplantation could be clinically useful therapeutic approaches for treating SCI.
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PMID:A comparison of autologous and allogenic bone marrow-derived mesenchymal stem cell transplantation in canine spinal cord injury. 1955 80

MRI studies are of paramount importance for diagnosis and follow-up measurements during conservative and postinterventional management of vestibular schwannomas (VS). MRI findings that convey important information for hearing-preservation VS surgery are: length of tumor-cochlear nerve contact, involvement of the internal auditory canal, incomplete filling of internal auditory canal, tumor size less than 15 mm and the intralabyrinthine signal intensity on 3DFT-CISS gradient-echo images. Functional neuro-otologic studies of facial nerve function, hearing and vestibular/balance function provide a valuable means of assessment of the actual impairment of the functional status of the VS patient. Intraoperative monitoring of facial nerve function and hearing has been refined, resulting in improved final postoperative facial nerve and hearing outcomes in VS patients treated with microsurgery. Long-term results reported by teams practicing stereotactic radiosurgery or fractionated stereotactic radiotherapy have been very encouraging. On the other hand, conservative management appears to be a viable option for a select group of VS patients. The refinement of surgical technique has rendered surgery safer and less invasive, resulting in better functional outcomes. Steroid use is currently used postinterventionally to improve final hearing outcome, although with questionable effectiveness. Physical rehabilitation programs are applied to accelerate vestibular functional recovery postoperatively and there is weak evidence that early physical rehabilitation may improve the final facial nerve outcome. Quality-of-life measures have emerged as important determinants of final therapeutic decision-making. More studies with high levels of evidence are needed to support clinical decisions.
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PMID:Diagnosis and therapy of vestibular schwannoma. 1967 9

The neurodevelopmental disabilities of those who were born prematurely have been well described, yet the underlying alterations in brain development that lead to these changes remain poorly understood. Processes that are vulnerable to injury in the developing brain include maturation of oligodendrocyte precursors and genetically programmed changes in cortical connectivity; recent data have indicated that diffuse injury of the white matter accompanied by neuronal and axonal disruption is common in prematurely born infants. Recent advances in MRI include diffusion tensor imaging and sophisticated image analysis tools, such as functional connectivity, voxel-based morphometry, and mathematical morphology-based cortical folding strategies. These advanced techniques have shown that white matter structure is dependent on gestational age and have started to provide important information about the dynamic interactions between development, injury, and functional recovery in the preterm brain. Identification of early biomarkers for outcome could enable physicians and scientists to develop targeted pharmacological and behavioural therapies to restore functional connectivity.
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PMID:Imaging biomarkers of outcome in the developing preterm brain. 1980 Feb 93

In this study, we present a case of a very rare and large suprapatellar synovial cyst of the knee, which was successfully treated with an arthroscopic intra-articular decompression. Suprapatellar bursa is located between the femur and quadriceps tendon, proximal to the knee joint, and it normally communicates with a joint cavity. However, very rarely bursa can remain completely separated from the knee joint, which can result in the formation of a separated compartment inside which, in special circumstances, fluids can be accumulated and with time can lead to the formation of suprapatellar cyst. Although certain authors use ultrasound, arthrography and computerized tomography, MRI is recognized as the 'gold standard' in diagnostics of knee cysts. When considering ways of treatment, according to the available literature, suprapatellar cysts are treated mostly by an open excision, whereas in our case we managed to show that cysts could also be effectively and safely treated by arthroscopic decompression, with no recurrence and followed by fast and functional recovery.
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PMID:Large suprapatellar synovial cyst in a 12-year-old girl: arthroscopic decompression. 1989 56

The use of nanotechnology in cell therapy and tissue engineering offers promising future perspectives for brain and spinal cord injury treatment. Stem cells have been shown to selectively target injured brain and spinal cord tissue and improve functional recovery. To allow cell detection, superparamagnetic iron-oxide nanoparticles can be used to label transplanted cells. MRI is then a suitable method for the in vivo tracking of grafted cells in the host organism. CNS, and particularly spinal cord, injury is accompanied by tissue damage and the formation of physical and biochemical barriers that prevent axons from regenerating. One aspect of nanomedicine is the development of biologically compatible nanofiber scaffolds that mimic the structure of the extracellular matrix and can serve as a permissive bridge for axonal regeneration or as a drug-delivery system. The incorporation of biologically active epitopes and/or the utilization of these scaffolds as stem cell carriers may further enhance their therapeutic efficacy.
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PMID:Nanotechnology for treatment of stroke and spinal cord injury. 2002 68


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