中山大学附属第三医院康复科,广东 广州 510630
[ "胡昔权,教授,主任医师,中山大学附属第三医院康复科副主任、岭南医院康复科主任,精神与神经疾病研究中心副主任。入选“广东省医学领军人才”。现任中华医学会物理医学与康复学分会副主委、中国康复医学会脑血管病专业委员会和脑功能检测与调控康复专委会副主委,广东省医学会物理医学与康复学分会主任委员、广东省医师协会康复科医师分会候任主委、广东省康复医学会副会长兼神经康复分会会长,国家自然科学基金二审专家等。主研方向为脑损伤后运动、认知等功能障碍的康复及其神经可塑性机制。主持各级科研课题18项,其中国家自然科学基金面上项目4项、广东省自然科学基金重点项目1项;已发表论文百余篇,近5年以通讯作者在 《Neurorehab Neural Re》《Med Sci Sport Exer》《Cell Death Dis》等杂志发表论文20余篇;获2018年中国康复医学会科学技术奖一等奖;主编副主编《神经康复学》《神经疾患康复治疗技术》《实用瘫痪康复》等6部专著/教材,参编专著10余部。E-mail: xiquhu@hotmail.com。" ]
收稿:2021-06-07,
纸质出版:2021-07-20
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胡昔权.运动训练促进脑卒中后神经可塑性的机制研究[J].中山大学学报(医学科学版),2021,42(04):481-486.
HU Xi-quan.Advances in the Mechanism of Physical Exercise Promoting Neuroplasticity after Stroke[J].Journal of Sun Yat-sen University(Medical Sciences),2021,42(04):481-486.
胡昔权.运动训练促进脑卒中后神经可塑性的机制研究[J].中山大学学报(医学科学版),2021,42(04):481-486. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0401.
HU Xi-quan.Advances in the Mechanism of Physical Exercise Promoting Neuroplasticity after Stroke[J].Journal of Sun Yat-sen University(Medical Sciences),2021,42(04):481-486. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0401.
运动训练是脑卒中后康复治疗的主要手段。运动训练可以促进脑卒中后神经功能的恢复,其作用目前普遍认为与神经可塑性有关,但具体机制未明。运动训练的神经可塑性机制是当前脑卒中康复研究领域的热点问题。运动训练可以调节脑卒中后脑内血流动力学变化、血管新生、神经炎症反应、营养因子分泌、神经细胞死亡及新生等。本文基于国内外研究,探讨脑卒中后最适的运动干预方案,并结合我们团队在运动训练促进脑卒中后神经功能恢复方向所做的系列研究工作,对运动训练促进脑卒中后神经可塑性的机制研究进行综述。
Physical exercise is the main method of rehabilitation treatment after stroke. Physical exercise can promote the neurological function recovery, which is generally considered to be related with neuroplasticity after stroke. However, the mechanism remains unclear. The mechanism of neuroplasticity promoted by physical exercise is a research focus in the stroke rehabilitation area. Current studies suggest that physical exercise regulates cerebral hemodynamic changes, angiogenesis, neuroinflammatory response, secretion of nutritional factors, nerve cells death and regeneration after stroke. Based on recent studies, we explore the optimal time and dosage of physical exercise and combine our work in physical exercise promoting neurological function recovery to review the mechanism of physical exercise promoting neuroplasticity after stroke.
Zhang L , Yang X , Yin M , et al . An animal trial on the optimal time and intensity of exercise after stroke [J]. Med Sci Sports Exerc , 2020 , 52 ( 8 ): 1699 - 1709 .
Zhang L , Hu X , Luo J , et al . Physical exercise improves functional recovery through mitigation of autophagy, attenuation of apoptosis and enhancement of neurogenesis after MCAO in rats [J]. BMC Neurosci , 2013 , 14 : 46 .
Zheng HQ , Zhang LY , Luo J , et al . Physical exercise promotes recovery of neurological function after ischemic stroke in rats [J]. Int J Mol Sci , 2014 , 15 ( 6 ): 10974 - 10988 .
Pan X , Jiang T , Zhang L , et al . Physical exercise promotes novel object recognition memory in spontaneously hypertensive rats after ischemic stroke by promoting neural plasticity in the entorhinal cortex [J]. Front Behav Neurosci , 2017 , 11 : 185 .
Huang M , Xiao C , Zhang L , et al . Bioinformatic analysis of exosomal micrornas of cerebrospinal fluid in ischemic stroke rats after physical exercise [J]. Neurochem Res , 2021 , 46 ( 6 ): 1540 - 1553 .
Luo J , Hu X , Zhang L , et al . Physical exercise regulates neural stem cells proliferation and migration via SDF-1α/CXCR4 pathway in rats after ischemic stroke [J]. Neurosci Lett , 2014 , 578 : 203 - 208 .
Egan KJ , Janssen H , Sena ES , et al . Exercise reduces infarct volume and facilitates neurobehavioral recovery: results from a systematic review and meta-analysis of exercise in experimental models of focal ischemia [J]. Neurorehabil Neural Repair , 2014 , 28 ( 8 ): 800 - 812 .
Austin MW , Ploughman M , Glynn L , et al . Aerobic exercise effects on neuroprotection and brain repair following stroke: a systematic review and perspective [J]. Neurosci Res , 2014 , 87 : 8 - 15 .
Zhang P , Yu H , Zhou N , et al . Early exercise improves cerebral blood flow through increased angiogenesis in experimental stroke rat model [J]. J Neuroeng Rehabil , 2013 , 10 : 43 .
Hu X , Zheng H , Yan T , et al . Physical exercise induces expression of CD31 and facilitates neural function recovery in rats with focal cerebral infarction [J]. Neurol Res , 2010 , 32 ( 4 ): 397 - 402 .
郑海清 , 胡昔权 , 方杰 , 等 . 运动训练对脑梗死大鼠梗死边缘区突触可塑性的影响 [J]. 中华医学杂志 , 2012 , ( 9 ): 628 - 633 .
Zheng HQ , Hu XQ , Fang J , et al . Effects of exercise training on synaptic plasticity in rats with focal cerebral infarction [J]. Natl Med J China , 2012 , ( 9 ): 628 - 633 .
Bland ST , Pillai RN , Aronowski J , et al . Early overuse and disuse of the affected forelimb after moderately severe intraluminal suture occlusion of the middle cerebral artery in rats [J]. Behav Brain Res , 2001 , 126 ( 1-2 ): 33 - 41 .
Cooke EV , Mares K , Clark A , et al . The effects of increased dose of exercise-based therapies to enhance motor recovery after stroke: a systematic review and meta-analysis [J]. BMC Med , 2010 , 8 : 60 .
Yang YR , Wang RY , Wang PS . Early and late treadmill training after focal brain ischemia in rats [J]. Neurosci Lett , 2003 , 339 ( 2 ): 91 - 94 .
Risedal A , Zeng J , Johansson BB . Early training may exacerbate brain damage after focal brain ischemia in the rat [J]. J Cereb Blood Flow Metab , 1999 , 19 ( 9 ): 997 - 1003 .
Morreale M , Marchione P , Pili A , et al . Early versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: proprioceptive or cognitive approach? [J]. Eur J Phys Rehabil Med , 2016 , 52 ( 1 ): 81 - 89 .
Sundseth A , Thommessen B , Rønning OM . Early mobilization after acute stroke [J]. J Stroke Cerebrovasc Dis , 2014 , 23 ( 3 ): 496 - 499 .
AVERT Trial Collaboration group . Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial [J]. Lancet , 2015 , 386 ( 9988 ): 46 - 55 .
Langhorne P , Wu O , Rodgers H , et al . A Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial [J]. Health Technol Assess , 2017 , 21 ( 54 ): 1 - 120 .
Bernhardt J . Early mobilisation and rehabilitation in intensive care unit-ready for implementation? [J]. Ann Transl Med, 2017 , 5 ( 3 ): 57 .
Hasan SM , Rancourt SN , Austin MW , et al . Defining optimal aerobic exercise parameters to affect complex motor and cognitive outcomes after stroke: A systematic review and synthesis [J]. Neural Plast , 2016 , 2016 : 2961573 .
Herisson F , Godard S , Volteau C , et al . Early sitting in ischemic stroke patients (SEVEL): A randomized controlled trial [J]. PLoS One , 2016 , 11 ( 3 ): e0149466 .
An H , Ford AL , Chen Y , et al . Defining the ischemic penumbra using magnetic resonance oxygen metabolic index [J]. Stroke , 2015 , 46 ( 4 ): 982 - 988 .
Liao CH , Liao NC , Chen WH , et al . Penumbra volume predicts unfavorable outcome in patients with acute minor stroke or transient ischemic attack [J]. J Chin Med Assoc , 2020 , 83 ( 6 ): 551 - 556 .
Uzdensky AB . Apoptosis regulation in the penumbra after ischemic stroke: expression of pro- and antiapoptotic proteins [J]. Apoptosis , 2019 , 24 ( 9-10 ): 687 - 702 .
Puyal J , Clarke PG . Targeting autophagy to prevent neonatal stroke damage [J]. Autophagy , 2009 , 5 ( 7 ): 1060 - 1061 .
Tuo QZ , Lei P , Jackman KA , et al . Tau-mediated iron export prevents ferroptotic damage after ischemic stroke [J]. Mol Psychiatry , 2017 , 22 ( 11 ): 1520 - 1530 .
Datta A , Sarmah D , Mounica L , et al . Cell death pathways in ischemic stroke and targeted pharmacotherapy [J]. Transl Stroke Res , 2020 , 11 ( 6 ): 1185 - 1202 .
Deng Y , Chen D , Gao F , et al . Silencing of long non-coding RNA GAS5 suppresses neuron cell apoptosis and nerve injury in ischemic stroke through inhibiting DNMT3B-dependent MAP4K4 methylation [J]. Transl Stroke Res , 2020 , 11 ( 5 ): 950 - 966 .
Siniscalchi A , Gallelli L , Malferrari G , et al . Cerebral stroke injury: the role of cytokines and brain inflammation [J]. J Basic Clin Physiol Pharmacol , 2014 , 25 ( 2 ): 131 - 137 .
Boutin H , LeFeuvre RA , Horai R , et al . Role of IL-1alpha and IL-1beta in ischemic brain damage [J]. J Neurosci , 2001 , 21 ( 15 ): 5528 - 5534 .
Clausen BH , Lambertsen KL , Babcock AA , et al . Interleukin-1beta and tumor necrosis factor-alpha are expressed by different subsets of microglia and macrophages after ischemic stroke in mice [J]. J Neuroinflammation , 2008 , 5 : 46 .
Arvin B , Neville LF , Barone FC , et al . The role of inflammation and cytokines in brain injury [J]. Neurosci Biobehav Rev , 1996 , 20 ( 3 ): 445 - 452 .
Xing C , Wang X , Cheng C , et al . Neuronal production of lipocalin-2 as a help-me signal for glial activation [J]. Stroke , 2014 , 45 ( 7 ): 2085 - 2092 .
Benarroch EE . Oligodendrocytes: Susceptibility to injury and involvement in neurologic disease [J]. Neurology , 2009 , 72 ( 20 ): 1779 - 1785 .
Liu W , Tang Y , Feng J . Cross talk between activation of microglia and astrocytes in pathological conditions in the central nervous system [J]. Life Sci , 2011 , 89 ( 5-6 ): 141 - 146 .
Shinozaki Y , Shibata K , Yoshida K , et al . Transformation of astrocytes to a neuroprotective phenotype by microglia via P2Y(1) receptor downregulation [J]. Cell Rep , 2017 , 19 ( 6 ): 1151 - 1164 .
Huang Z , Liu J , Cheung PY , et al . Long-term cognitive impairment and myelination deficiency in a rat model of perinatal hypoxic-ischemic brain injury [J]. Brain Res , 2009 , 1301 : 100 - 109 .
Jiang T , Zhang L , Pan X , et al . Physical exercise improves cognitive function together with microglia phenotype modulation and remyelination in chronic cerebral hypoperfusion [J]. Front Cell Neurosci , 2017 , 11 : 404 .
Cserép C , Pósfai B , Lénárt N , et al . Microglia monitor and protect neuronal function through specialized somatic purinergic junctions [J]. Science , 2020 , 367 ( 6477 ): 528 - 537 .
Nakagawa Y , Chiba K . Diversity and plasticity of microglial cells in psychiatric and neurological disorders [J]. Pharmacol Ther , 2015 , 154 : 21 - 35 .
Liddelow SA , Guttenplan KA , Clarke LE , et al . Neurotoxic reactive astrocytes are induced by activated microglia [J]. Nature , 2017 , 541 ( 7638 ): 481 - 487 .
Li L , Saliba P , Reischl S , et al . Neuronal deficiency of HIF prolyl 4-hydroxylase 2 in mice improves ischemic stroke recovery in an HIF dependent manner [J]. Neurobiol Dis , 2016 , 91 : 221 - 235 .
Ma Y , He M , Qiang L . Exercise therapy downregulates the overexpression of TLR4, TLR2, MyD88 and NF-κB after cerebral ischemia in rats [J]. Int J Mol Sci , 2013 , 14 ( 2 ): 3718 - 3733 .
Di Benedetto S , Müller L , Wenger E , et al . Contribution of neuroinflammation and immunity to brain aging and the mitigating effects of physical and cognitive interventions [J]. Neurosci Biobehav Rev , 2017 , 75 : 114 - 128 .
He XF , Liu DX , Zhang Q , et al . Voluntary exercise promotes glymphatic clearance of amyloid beta and reduces the activation of astrocytes and microglia in aged mice [J]. Front Mol Neurosci , 2017 , 10 : 144 .
Mee-Inta O , Zhao ZW , Kuo YM . Physical exercise inhibits inflammation and microglial activation [J]. Cells , 2019 , 8 ( 7 ): 691 .
Ieraci A , Mallei A , Musazzi L , et al . Physical exercise and acute restraint stress differentially modulate hippocampal brain-derived neurotrophic factor transcripts and epigenetic mechanisms in mice [J]. Hippocampus , 2015 , 25 ( 11 ): 1380 - 1392 .
Belaya I , Ivanova M , Sorvari A , et al . Astrocyte remodeling in the beneficial effects of long-term voluntary exercise in Alzheimer's disease [J]. J Neuroinflammation , 2020 , 17 ( 1 ): 271 .
Huang K , Du J , Ma N , et al . GATA2(-/-) human ESCs undergo attenuated endothelial to hematopoietic transition and thereafter granulocyte commitment [J]. Cell Regen , 2015 , 4 ( 1 ): 4 .
Liu J , Solway K , Messing RO , et al . Increased neurogenesis in the dentate gyrus after transient global ischemia in gerbils [J]. J Neurosci , 1998 , 18 ( 19 ): 7768 - 7778 .
Jiang W , Gu W , Brännström T , et al . Cortical neurogenesis in adult rats after transient middle cerebral artery occlusion [J]. Stroke , 2001 , 32 ( 5 ): 1201 - 1207 .
Saha B , Peron S , Murray K , et al . Cortical lesion stimulates adult subventricular zone neural progenitor cell proliferation and migration to the site of injury [J]. Stem Cell Res , 2013 , 11 ( 3 ): 965 - 977 .
Wu R , Luo S , Yang H , et al . Transplantation of neural progenitor cells generated from human urine epithelial cell-derived induced pluripotent stem cells improves neurological functions in rats with stroke [J]. Discov Med , 2020 , 29 ( 156 ): 53 - 64 .
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