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Brain Dysfunction > Lecture 11 - Plasticity & Recovery > Flashcards

Lecture 11 - Plasticity & Recovery Flashcards

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1
Q

What are the symptoms after a stroke (middle cerebral artery stroke) ?

A
  • Contralateral paralysis
  • Contralateral sensory loss
  • Global aphasia
  • Contralateral neglect
  • Cognitive problems
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2
Q

What are the 3 subphases of the recovery phase after a stroke ?

A
  • Acute phase (1-7 days)
  • Subacute phase : early (7 days - 3 months) & late (3 - 6 months)
  • Chronic phase (>6 months)
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3
Q

What are the two main ways neuroplasticity occurs ?

A
  • Change of physical structure
  • Compensation of function within the existing structure
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4
Q

What is neuroplasticity ?

A

Ability of NS to reorganize its structure, function or connections

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5
Q

At which levels can plasticity be analyzed ?

A
  • Behavior
  • Cortical maps
  • Physiology
  • Synaptic organization
  • Mitotic activity
  • Molecular structure
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6
Q

What are the two general types of plasticity ?

A
  • Experience expectant
  • Experience dependent
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6
Q

What does plasticity correlate with ?

A

Behavioral changes

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7
Q

What is meta-plasticity ?

A

The interaction of plasticity with the environment

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8
Q

What are the dependencies of plasticity ?

A
  • Age-dependency
  • Time-dependency
  • Relevance-dependency
  • Intensity & frequency dependency
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9
Q

What are examples of plasticity at the level of cortical maps ?

A
  • Focal hand dystonia
  • Phantom limb reorganization
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10
Q

What are examples of plasticity at the level of physiology ?

A
  • LT potentiation
  • Kindling (seizure activity)
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11
Q

What is an example of plasticity at the level of synaptic organization ?

A
  • Experience-dependent changes in dendritic arborization
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12
Q

What is an example of plasticity at the level of mitotic activity ?

A
  • Continuation of neurogenesis of the olfactory bulb, hippocampus & striatum
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13
Q

What is an example of plasticity at the level of molecular structure ?

A
  • Gene expression
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14
Q

What characterizes experience-expectant plasticity ?

A
  • General input (visual, orientation movement..)
  • Critical periods during developments
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15
Q

What characterizes experience-dependent plasticity ?

A
  • Specific personal input (learning or expansion of topographical maps…)
  • Modification of neuronal ensembles that are already present
16
Q

What are examples of meta-plasticity ?

A
  • Stimulant drugs & effects of complex environments
  • Early life stress & effects of complex environments
17
Q

What are examples of maladaptive plasticity ?

A
  • Drugs & stress exposure
  • Frontal lobe injury
  • Phantom limb pain
  • Focal hand dystonia
  • Dementia
18
Q

What constitutes “recovery” after brain injury ?

A
  • Compensation vs functional restitution
  • Recovery of lost capacity, or new way of functioning to compensate
19
Q

What is an example used to illustrate compensation versus functional restitution ?

A

3 legged cat

20
Q

What is the goal of rehabilitation after brain injury ?

A
  • Stimulate plasticity to provide the best possible compensation
21
Q

What happened after an ischemic accident ?

A
  • Ionic changes
  • Glutamate increase
  • Opening calcium channels (toxic calcium levels in the cell, neuronal damage)
  • mRNA : toxic production of proteins
  • Inflammation, swelling
  • Diaschisis
  • Change in metabolism & glucose utilization
22
Q

What are some prevention treatments in the acute phase of brain injury (ischemia) ?

A
  • Block calcium channels (neuroprotectant drugs)
  • Reduce inflammation (anti-inflammatory drugs)
23
Q

What are the different ways of recovery after brain injury?

A
  • Early rehabilitation : stimulating function recovery
  • Late/cognitive rehabilitation : functional recovery
  • Neuropsychological rehabilitation
  • Injury-induced change : spontaneous recovery
  • Experience-dependent change : learning
24
Q

What are the three aspects of neuropsychological rehabilitation ?

A
  • (Learning to) accept changes
  • (Learning to) adapt to changes
  • (Learning to) deal with changes
25
Q

What are some examples of recovery after brain injury ?

A
  • Recovery from motor-cortex damage
  • Recovery from aphasia
  • Recovery from traumatic lesions
  • Recovery from surgical lesions
  • Return to daily life
26
Q

What happens when there is a blockade of the middle cerebral artery in the motor cortex ?

A
  • Hemiplegia
  • Flaccidity of muscles
  • Loss of reflexive & voluntary movements
27
Q

What are the stages of recovery after injury to the motor cortex ?

A
  • Return of reflexes
  • Development of rigidity
  • Grasping as part of other movements
  • Voluntary grasping (23-40 days after injury)
28
Q

What are some common issues stroke survivors face in returning to daily life ?

A
  • Concentration & memory problems
  • Mental slowing, reduced task load (fatigue)
  • Problems with emotional regulation (irritability)
  • Psychological problems (anxiety/depression)
  • Mourning or acceptance of lost function
29
Q

What are some variables that affect recovery from brain injury ?

A
  • Age
  • Sex
  • Handedness
  • Premorbid IQ
  • Personality
  • Motivation
30
Q

What are some therapeutic approaches to brain injury recovery ?

A
  • Activity-based therapies
  • Cognitive rehabilitation
  • Tactile stimulation
  • Brain stimulation
  • Pharmacological therapies
  • Cell-based therapies
  • Music & other therapies
31
Q

What are some examples of activity-based therapies ?

A
  • Constraint-induces movement therapy
  • Physiotherapy
  • Speech therapy
32
Q

What are the benefits of brain stimulation therapy in brain injury recovery ?

A
  • rTMS : increased activity & stimulates plasticity within first month
  • DBS : used for Parkinson, depression & stroke
  • Vagus nerve stimulation : stimulates release of acetylcholine & norepinephrine
33
Q

What is the role of pharmacological therapies in stroke recovery ?

A
  • Prevention in acute stroke : tissue plasminogen activator (tA) & thrombectomy
  • Stimulating plasticity : amphetamine, nicotine, cannabis (for smaller lesions)
  • Enhance axonal sprouting : antibody to Nogo-A
  • Growths factors

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