《中国康复理论与实践》

《中国康复理论与实践》 ›› 2012, Vol. 18 ›› Issue (1): 47-52.

• 论文 • 上一篇    下一篇

丰富环境与脑卒中康复

李娴1,2，谢斌1   

  1. 1. 北京大学第一医院物理康复科，北京市 100034；2. 中山大学中山医学院康复治疗学系，广东广州市 510080。
  • 收稿日期:2011-08-29 修回日期:1900-01-01 出版日期:2012-01-25 发布日期:2012-01-25

Enriched Environment and Stroke Rehabilitation (review)

LI Xian, XIE Bin.   

  1. Department of Physical Medicine & Rehabilitation, Peking University First Hospital, Beijing 100034, China
  • Received:2011-08-29 Revised:1900-01-01 Published:2012-01-25 Online:2012-01-25

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被引次数

32

摘要： 丰富环境指的是能增加感觉、认知、活动及社交刺激的居住条件。动物实验显示丰富环境引起分子、细胞和行为学上的改变。实验性缺血后饲养于丰富环境可提高功能性结果，修饰基因的活化，改变N-甲基-D-天冬氨酸盐(NMDA)及α-氨基-3-羧基-5-甲基异恶唑-4-丙酸(AMPA)受体亚单位的表达，增加树突分支和损伤对侧Ⅱ/Ⅲ皮层椎体神经元树突棘的数量。同时，丰富环境可以影响损伤所致神经祖细胞的分化，增加移植干细胞向损伤区域转移。丰富环境理念在脑卒中康复中得到一定应用并越来越得到关注。本文将总结丰富环境对实验性梗死后康复的作用及丰富环境理念在临床中的应用。

关键词: 丰富环境, 脑卒中, 脑梗死, 基因活化, 树突棘, 突触结构, 祖细胞分化, 神经移植

Abstract: An enriched environment refers to conditions that facilitate sensory, cognitive, motor, and social stimulation. Behavioural,cellular and molecular studies have revealed significant effects of enriched environments on rodents and other species. Post-ischemic housing in an enriched environment improves functional outcome, modifies gene activation, induces alterations in the expression of N-methyl-D-aspartic acid (NMDA) and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor subunits, increases dendrite branching and number of dendritic spine in pyramidal neurons in layers II/III in the contra-lateral cortex, induces structural changes in synaptic junctions. Furthermore, it alters lesion-induced progenitor cell differentiation and interacts with necrotic grafting. The idea of environmental enrichment has been applied to clinical stroke rehabilitation and is getting more and more attention. This review will summarize experimental effects of enriched environment on post-ischemic rehabilitation and the clinical application of enriched environment in stroke rehabilitation.

Key words: enriched environment, stroke, cerebral infarction, gene activation, dendritic spine, synaptic junction, progenitor cell differentiation, neocortic grafting