Preconditioning with an Enriched Environment Enhances Neuroplasticity and Functional Recovery Following Cerebral Ischemia-Reperfusion Injury

 Ask your competent? doctor EXACTLY HOW TO PREDICT YOUR NEXT STROKE, so you can do this enriched environment ahead of time! Even post stroke it helps which your competent? doctor delivered to you 14 years ago. Right? 

This enriched environment  was reported for stroke way back in 2011 by Dr. Corbett. 

Preconditioning with an Enriched Environment Enhances Neuroplasticity and Functional Recovery Following Cerebral Ischemia-Reperfusion Injury

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https://doi.org/10.1016/j.brainresbull.2025.111459Get rights and content

Under a Creative Commons license

Open access

Highlights

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  EE preconditioning improved post-stroke neurological function and reduced damage.
• •
  It elevated neuroplasticity proteins (NF, Syn, MAP-2) in the brain.
• •
  Increased neurotrophic factors (NGF, bFGF) correlated with functional recovery.
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  EE may prevent/rehabilitate ischemic stroke by enhancing neuroplasticity mechanisms.

Abstract

Background

This study aimed to examine the effects of preconditioning with an enriched environment (EE) on neuroplasticity following cerebral ischemia-reperfusion (I/R) injury and to elucidate its underlying neuroprotective mechanisms. While prior research has indicated that EE preconditioning may mitigate neuronal apoptosis, the molecular pathways contributing to neuroplasticity enhancement post-I/R injury remain insufficiently characterized.

Methods

Male Sprague-Dawley rats were allocated into three experimental groups: (1) Middle cerebral artery occlusion (MCAO) with pre-ischemic EE exposure (PIEE), (2) pre-ischemic standard condition (SC) exposure with MCAO (PISC), and (3) pre-ischemic SC exposure with sham surgery (Sham). Neurological function and infarct volume were assessed three days post-MCAO. The expression levels of neuroplasticity-related proteins, including neurofilament (NF), synaptophysin (Syn), and microtubule-associated protein 2 (MAP-2), as well as neurotrophic factors such as nerve growth factor (NGF) and basic fibroblast growth factor (bFGF), were analyzed using western blot and immunohistochemical techniques. Correlation analyses were conducted to evaluate the relationship between protein expression and neurological outcomes.

Results

Compared to the PISC group, the PIEE group demonstrated significant improvements in neurological function and reduced infarct volumes. Expression levels of NF, Syn, and MAP-2 were elevated in the ischemic penumbra cortex in the PIEE group. Additionally, EE preconditioning resulted in increased expression of NGF and bFGF. These molecular changes were positively correlated with functional recovery in the MCAO model.

Conclusions

Pre-ischemic exposure to an enriched environment may enhance neuroplasticity and support functional recovery following cerebral I/R injury, potentially through the upregulation of neuroplasticity-associated proteins and neurotrophic factors. These findings support the development of EE-based interventions for ischemic stroke prevention and rehabilitation.

Enhancing the alignment of the preclinical and clinical stroke recovery research pipeline: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable translational working group

So they are saying stroke recovery research is difficult. Well that seems to be news to our fucking failures of stroke associations. World stroke day last year had a meme of 'stroke is treatable' . I snorted coffee thru my nose on that bald-faced lie. And these three guys I consider to be among the best stroke researchers out there. 8 posts on Dr. Corbett. 7 posts on Dr. Carmichael.
1 post on Dr. Murphy although he has numerous articles in Sage  Journals.

http://journals.sagepub.com/doi/full/10.1177/1747493017711814

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Dale Corbett, S Thomas Carmichael, Timothy H Murphy, ...

First Published July 12, 2017 Research Article

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Abstract

Stroke recovery research involves distinct biological and clinical targets compared to the study of acute stroke. Guidelines are proposed for the pre-clinical modeling of stroke recovery and for the alignment of pre-clinical studies to clinical trials in stroke recovery.

Keywords Rehabilitation, stroke recovery, translational medicine, stroke, consensus, neurorehabilitation, neurorecovery

Introduction

Moving treatments from the preclinical to the clinical realms is notoriously difficult. For all diseases, only 10% of agents that enter phase 1 trials result in a clinically used drug.^1,2 The success rate in stroke and traumatic brain injury is also low and well-documented.^3–5 The translational failure in stroke has been attributed to the narrow therapeutic window and to mistakes such as very broad inclusion criteria, and imprecise, global outcome measures.^3–5 On the preclinical side, depth and rigor of study design, analysis and interpretation have received special focus.
Stroke recovery involves distinct biological principles and a very different time window compared to stroke neuroprotection.^6–8 Unlike acute stroke, post-stroke behavioral activity shapes recovery and can be manipulated to promote recovery, or to negatively interact with recovery.^6,9 In addition, stroke recovery involves a unique biology of altered synaptic signaling, enhanced synaptic plasticity and changes in neuronal circuits that provide novel drug and cellular targets but also raise special considerations in clinical translation. The special considerations include: the animal stroke models, the tissue and behavioral outcome measures, imaging biomarkers and conceptual management of the full translational pipeline.
Recent conceptual and technological developments in neuroscience are bringing promising physical, pharmacological and cellular therapies to the field of neurorehabilitation and brain repair. This paper outlines a series of guidelines and recommendations specifically tailored to enhance the quality and rigor of preclinical stroke recovery research.
The task of the translational working group of the Stroke Recovery and Rehabilitation Roundtable (SRRR)¹⁰ was to develop a set of guidelines and recommendations appropriate for preclinical stroke recovery research. Existing preclinical stroke research recommendation papers (e.g. STAIR, STEPS) focus chiefly on acute stroke.^11,12 Although cognitive impairments and depression are common after stroke,¹³ the SRRR working groups concluded that these topics require a subsequent roundtable discussion so the emphasis here is on preclinical sensorimotor recovery. The ultimate goal of the translational group was to align preclinical to clinical stroke recovery studies so as to avoid past mistakes and maximize clinical translation.

More at link.

Exploring the Safety and Therapeutic Effects of Deep Pressure Stimulation Using a Weighted Blanket

Maybe you could use these to reduce your anxiety about never getting back to 100% recovery. I bet this would also be good for extra sensation, An extra 8-10 hours of therapy where you do nothing but sleep and get weighted down.  I do wonder if these would stay in place as I try to change positions during the night? I have major trouble keeping my covers over my affected side as I move. This is commonly used for autistic kids. I bet it might work in PTSD. But don't do this dangerous therapy without your doctors prescription.This could easily become  a standard part of the enriched environment as talked about by Dr. Dale Corbett in 2011.

Exploring the Safety and Therapeutic Effects of Deep Pressure Stimulation Using a Weighted Blanket

Brian Mullen BS , Tina Champagne MEd, OTR/L , Sundar Krishnamurty PhD , Debra Dickson APRN, BC & Robert X. Gao PhD

Pages 65-89 | Received 03 May 2006, Accepted 08 Dec 2006, Published online: 08 Sep 2008

• Download citation
• http://dx.doi.org/10.1300/J004v24n01_05

Abstract

This paper presents the results of a concurrent, nested, mixed methods exploratory study on the safety and effectiveness of the use of a 30 lb weighted blanket with a convenience sample of 32 adults. Safety is investigated measuring blood pressure, pulse rate, and pulse oximetry, and effectiveness by electrodermal activity (EDA), the State Trait Anxiety Inventory-10 and an exit survey. The results reveal that the use of the 30 lb weighted blanket, in the lying down position, is safe as evidenced by the vital sign metrics. Data obtained on effectiveness reveal 33% demonstrated lowering in EDA when using the weighted blanket, 63% reported lower anxiety after use, and 78% preferred the weighted blanket as a calming modality. The results of this study will be used to form the basis for subsequent research on the therapeutic influence of the weighted blanket with adults during an acute inpatient mental health admission.

Moving rehabilitation research forward: Developing consensus statements for rehabilitation and recovery research

Lots of important people in this list; Carmichael, Corbett, Cramer,
http://wso.sagepub.com/content/early/2016/04/12/1747493016643851.abstract?

1. Julie Bernhardt1,2⇑
2. Karen Borschmann1,2
3. Lara Boyd3
4. S Thomas Carmichael4
5. Dale Corbett5,6
6. Steven C Cramer7
7. Tammy Hoffmann8
8. Gert Kwakkel9
9. Sean I Savitz10
10. Gustavo Saposnik11,12
11. Marion Walker13
12. Nick Ward14,15

1. ¹NHMRC Centre for Research Excellence in Stroke Rehabilitation and Recovery, Victoria, Australia
2. ²The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
3. ³Department of Physical Therapy and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, BC, Canada
4. ⁴Departments of Neurology and Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, USA
5. ⁵Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
6. ⁶Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, Canada
7. ⁷Departments of Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, University of California, Irvine, USA
8. ⁸Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Queensland, Australia
9. ⁹Department of Rehabilitation Medicine, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
10. ¹⁰Stroke Program, McGovern Medical School, UTHealth, Houston, Texas, USA
11. ¹¹Department of Medicine, University of Toronto, Toronto, Canada
12. ¹²Stroke Outcomes Research Center, Li Ka Shing Knowledge Institute, Toronto, Canada
13. ¹³Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
14. ¹⁴Sobell Department of Motor Neuroscience UCL Institute of Neurology, Queen Square, London, UK
15. ¹⁵National Hospital for Neurology and Neurosurgery, Queen Square, London, UK

1. Julie Bernhardt, The Florey Institute of Neuroscience and Mental Health, 245 Burgundy Street Heidelberg, Victoria 3084 Australia. Email: julie.bernhardt@florey.edu.au

Abstract

Stroke recovery is the next frontier in stroke medicine. While growth in rehabilitation and recovery research is exponential, a number of barriers hamper our ability to rapidly progress the field. Standardized terminology is absent in both animal and human research, methods are poorly described, recovery biomarkers are not well defined, and we lack consistent timeframes or measures to examine outcomes. Agreed methods and conventions for developing, monitoring, evaluating and reporting interventions directed at improving recovery are lacking, and current approaches are often not underpinned by biology. We urgently need to better understand the biology of recovery and its time course in both animals and humans to translate evidence from basic science into clinical trials. A new international partnership of stroke recovery and rehabilitation experts has committed to advancing the research agenda. In May 2016, the first Stroke Recovery and Rehabilitation Roundtable will be held, with the aim of achieving an agreed approach to the development, conduct and reporting of research. A range of methods will be used to achieve consensus in four priority areas: pre-clinical recovery research; biomarkers of recovery; intervention development, monitoring and reporting; and measurement in clinical trials. We hope to foster a global network of researchers committed to advancing this exciting field. Recovery from stroke is challenging for many survivors. They deserve effective treatments underpinned by our evolving understanding of brain recovery and human behaviour. Working together, we can develop game-changing interventions to improve recovery and quality of life in those living with stroke.

Cancer Research UK invests £15 million to unite finest minds across UK to develop better treatments

The key point here is uniting the finest minds. In stroke nobody seems to want to attempt that. The WSO had their World Stroke Organization Synergium in 2010 and you can see why in my opinion it is totally worthless. You as a stroke survivor are totally screwed until the complete stroke leadership is deposed and removed from any part of this.
My list of finest minds:
Dr. Steven Wolf;
Peter Levine; 
Dr. S. Thomas Carmichael;
Dr. Bruce H. Dobkin;
Dr. Dale Corbett;
Dr. Michael Tymianski, of the Toronto Western Hospital Research Institute in Canada;
Dr. Michael A. Moskowitz ;
Dr. Watson, IBM computer;
Dr. Google;
myself;
Dr. Amy Shissler;
Barb Polan;
Jo Murphy;  
Rebecca Dutton; 
My list of those that should NOT be invited:
Dr. William M. Landau - his ideas on spasticity are appalling;
Matt Lopez, president of the NSA;
Dr. Mariel Jessup, president of the ASA;
WSO President - Steve Davis (Australia); 
Immediate Past-president WSO - Bo Norrving (Sweden)

http://www.alphagalileo.org/ViewItem.aspx?ItemId=157007&CultureCode=en

Multi-sensory room helps those suffering from strokes

This enriched environment  was reported for stroke way back in 2011 by Dr. Corbett. Only 3 years to do something so incredibly simple.  
Does your hospital have one?
http://www.mysuncoast.com/news/local/multi-sensory-room-helps-those-suffering-from-strokes/article_be12276a-e6ae-11e3-a35e-0017a43b2370.html 
Now a new multi-sensory room on the Suncoast helps stroke patients and others via neuro-rehabilitation.
Colors, lights, sounds and smells can awaken memories, like your favorite sunset on the gulf, mockingbirds, or a fresh cut lawn. And now a room dedicated to the senses helps Suncoast residents suffering stroke, dementia, and other conditions.
There is a soft blue light, a light citrus scent, and video projected on a wall. “When they walk in that room, their eyes light up,” says Heidi Brown, CEO of Kobernick Anchin Benderson.
The multi-sensory room at Anchin Pavilion makes a difference to residents, she says. “They're so excited to have the sights, and the smells, and the sounds that they're not having in the opportunity to experience on a day to day basis.”
Colors trigger emotions, but it’s not just the color that resident Helen Waldman likes. “It’s smooth, it feels smooth.”
She enjoys the nature scenes of butterflys. “And fish, because they're gentle.”
The variety of sensory stimulation helps many people, including those suffering stroke, says activities director April Moschini. “Usually people who have a stroke are affected on one side.”
Moving sand from one side to another incorporates both sides of the body. “Being able to use things that are tactile and using both of the sides of your body helps bring them back to baseline.”
The swinging chair awakens vestibular stimulation. “That is for somebody with limited mobility. It allows them to feel what it's like to move in space again.”
Registered nurse Judith Yaeger says she sneaks into the room every chance she gets to play with her personal favorite, the fiberoptic strands. “They change colors; they're not supposed to be warm, but they are a little warm, and they're just very relaxing, you can do all kinds of things with them.”
Moschini say dramatic changes occur with patients suffering aphasia, when a person's previous capacity to understand or express language is impaired. “They may suddenly be stimulated to be verbal, or vocalize something.”
Brown remembers the room’s effect on a specific non-verbal patient’s reaction. “She was actually able to smile and laugh, and have a conversation, and that's the benefit.”
Sensory perception and multi-sensory rooms and tools are used and help people with a number of conditions, including PTSD and brain trauma.
The multisensory room at Anchin Pavilion is open to the community, and receives outside clients by appointment. It is located at 1959 Honore Avenue in Sarasota.

Video at link.

Scientists discover environmental enrichment for TBI patients may counter shrinkage in the brain

This was reported for stroke way back in 2011 by Dr. Corbett. Don't researchers read research?
Get the summary here: http://www.eurekalert.org/pub_releases/2013-09/uhn-sde092413.php
Get the abstract here: Environmental enrichment may protect against hippocampal atrophy in the chronic stages of traumatic brain injury

An enriched environment increases activity in stroke patients undergoing rehabilitation in a mixed rehabilitation unit: a pilot non-randomized controlled trial

My God, why are we beating a known fact as talked about by Dr. Corbett in  2010.
They should be disseminating this to the overall Great Stroke Association to get this into every rehab hospital and textbook. Don't researchers read anything in their field? And how many years is it going to take to get to your hospital? You have to demand this, no one else will do it.
http://informahealthcare.com/doi/abs/10.3109/09638288.2013.788218

Abstract

Purpose: An enriched environment (EE) facilitates physical, cognitive and social activity in animal models of stroke. The aim of this pilot study was to determine whether enriching the environment of a mixed rehabilitation unit increased stroke patient activity. Methods: A non- randomized controlled trial was conducted. Direct observation was used to determine the difference in change in physical, cognitive, social or any activity over 2 weeks in patients exposed to an enriched versus non-enriched environment. Results: Stroke patients in the EE (n  = 15) were 1.2 (95% CI 1.0–1.4) times more likely to be engaged in any activity compared with those in a non-enriched environment (n =  14). They were 1.7 (95% CI 1.1–2.5) times more likely to be engaged in cognitive activities, 1.2 (95% CI 1.0–1.5) times more likely to be engaged in social activities, 0.7 (95% CI 0.6–0.9) times as likely to be inactive and alone and 0.5 (95% CI 0.4–0.7) times as likely to be asleep than patients without enrichment. Conclusions: This preliminary trial suggests that the comprehensive model of enrichment developed for use in a rehabilitation unit was effective in increasing activity in stroke patients and reducing time spent inactive and alone.Implications for Rehabilitation

• Stroke patients within a mixed rehabilitation unit who are exposed to an enriched environment (EE) are more likely to be engaged in activity than those not exposed to the enriched environment.
• Patients in enriched conditions are less likely to be “inactive and alone” or asleep during waking hours.
• These results suggest a comprehensive model of enrichment is effective in increasing activity levels.

Read More: http://informahealthcare.com/doi/abs/10.3109/09638288.2013.788218

Standardized Environmental Enrichment Supports Enhanced Brain Plasticity in Healthy Rats and Prevents Cognitive Impairment in Epileptic Rats

Our researchers should be able to apply and test this in survivors. This is what Dr. Corbett has been saying for years. Enrich your environment.
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0053888

Abstract

Environmental enrichment of laboratory animals influences brain plasticity, stimulates neurogenesis, increases neurotrophic factor expression, and protects against the effects of brain insult. However, these positive effects are not constantly observed, probably because standardized procedures of environmental enrichment are lacking. Therefore, we engineered an enriched cage (the Marlau™ cage), which offers: (1) minimally stressful social interactions; (2) increased voluntary exercise; (3) multiple entertaining activities; (4) cognitive stimulation (maze exploration), and (5) novelty (maze configuration changed three times a week). The maze, which separates food pellet and water bottle compartments, guarantees cognitive stimulation for all animals. Compared to rats raised in groups in conventional cages, rats housed in Marlau™ cages exhibited increased cortical thickness, hippocampal neurogenesis and hippocampal levels of transcripts encoding various genes involved in tissue plasticity and remodeling. In addition, rats housed in Marlau™ cages exhibited better performances in learning and memory, decreased anxiety-associated behaviors, and better recovery of basal plasma corticosterone level after acute restraint stress. Marlau™ cages also insure inter-experiment reproducibility in spatial learning and brain gene expression assays. Finally, housing rats in Marlau™ cages after severe status epilepticus at weaning prevents the cognitive impairment observed in rats subjected to the same insult and then housed in conventional cages. By providing a standardized enriched environment for rodents during housing, the Marlau™ cage should facilitate the uniformity of environmental enrichment across laboratories