I'm sure your wonderful up-to-date doctor can explain all this and how it is already incorporated into your 100% recovery protocol. You don't have a 100% recovery protocol? Why not? Is your doctor not any good?
Plasticity beyond peri-infarct cortex: Spinal up regulation of structural plasticity, neurotrophins, and inflammatory cytokines during recovery from cortical stroke
- a Centre for Neuroscience, University of Alberta, Edmonton, Alberta, Canada T6G 2R3
- b Faculty of Rehabilitative Medicine, University of Alberta, Edmonton, Alberta, Canada T6G 2R3
- c Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada T6G 2R3
- d Neurochemical Research Unit, University of Alberta, Edmonton, Alberta, Canada T6G 2R3
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- Cortical stroke induces heightened expression of GAP-43 in the spinal cord
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- Plasticity in the spinal cord after cortical stroke has a finite temporal window
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- TNF-α, IL-6, and NT-3 protein levels in spinal cord correlate with GAP-43 levels
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- BDNF increases transiently in spinal cord prior to heightened GAP-43 expression
Abstract
Stroke
induces pathophysiological and adaptive processes in regions proximal
and distal to the infarct. Recent studies suggest that plasticity at the
level of the spinal cord may contribute to sensorimotor recovery after
cortical stroke. Here, we compare the time course of heightened
structural plasticity in the spinal cord against the temporal profile of
cortical plasticity and spontaneous behavioural recovery. To examine
the relation between trophic and inflammatory effectors and spinal
structural plasticity, spinal expression of brain derived neurotrophic
factor (BDNF), neurotrophin-3 (NT-3), tumor necrosis factor-α (TNF-α),
and interleukin-6 (IL-6) were measured. Growth-associated protein 43
(GAP-43), measured at 3, 7, 14, or 28 days after photothrombotic stroke
of the forelimb sensorimotor cortex (FL-SMC) to provide an index of
periods of heightened structural plasticity, varied as a function of
lesion size and time after stroke in the cortical hemispheres and the
spinal cord. Notably, GAP-43 levels in the cervical spinal cord were
significantly increased after FL-SMC lesion, but the temporal window of
elevated structural plasticity was more finite in spinal cord relative
to ipsilesional cortical expression (returning to baseline levels by 28
post-stroke). Peak GAP-43 expression in spinal cord occurred during
periods of accelerated spontaneous recovery, as measured on the Montoya
Staircase reaching task, and returned to baseline as recovery plateaued.
Interestingly, spinal GAP-43 levels were significantly correlated with
spinal levels of the inflammatory cytokines TNF-α and IL-6 as well as
the neurotrophin NT-3, while a transient increase in BDNF levels
preceded elevated GAP-43 expression. These data identify a significant
but time-limited window of heightened structural plasticity in the
spinal cord following stroke that correlates with spontaneous recovery
and the spinal expression of inflammatory cytokines and neurotrophic
factors.
Abbreviations
- IC, ipsilesional cortex;
- CC, contralesional cortex;
- CSC, cervical spinal cord;
- LSC, lumbar spinal cord;
- FL-SMC, forelimb sensorimotor cortex;
- GAP-43, growth associated protein-43;
- TNF-α, tumor necrosis factor - alpha;
- IL-6, interleukin 6;
- BDNF, brain derived neurotrophic factor;
- NT-3, neurotrophin-3
Keywords
- Ischemia;
- Sensorimotor cortex;
- Plasticity;
- Spinal cord;
- Inflammation;
- Neurotrophins;
- GAP-43;
- TNF-alpha;
- IL-6;
- BDNF;
- NT-3
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