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Published on: April 10, 2019
Modified constraint-induced movement therapy improves functional recovery after ischemic stroke and its impacts on
Beiyao Gao1, Ruidong Ge1, Ying Xing2
1Department of Rehabilitation Medicine, China-Japan Friendship Hospital Beijing, China.
Objective:
To investigate whether modified constraint-induced movement therapy (mCIMT) improves brain function after stroke by increasing the concentrations of exosomes and microRNA.
Methods:
Blood samples from 16 stroke patients (mCIMT group N=8, control group N=8) were analyzed for cytokines and exosomal microRNAs. Data from electronic medical records and clinical outcomes were also correlated. For the animal model, SD rats underwent middle cerebral artery occlusion (MCAO). The mCIMT group received 2 hours of daily intensive limb training for 14 days, starting 7 days post-MCAO, while the control group was untreated. Exosomes were extracted from brain tissue on day 21, followed by nanoparticle tracking and microRNA sequencing. Exosomes from both groups, as well as a vehicle, were injected into the lateral ventricles of MCAO rats, and they were named the Exo-mCIMT group, Exo-control group and vehicle group. Behavioral tests and histopathological staining were performed on day 21 among the three groups.
Results:
mCIMT significantly increased exosome content in the plasma of stroke patients, with exosome size correlated with the Fugl-Meyer Motor Function Assessment (FMA-UE, R2=0.428). In rats, the mCIMT group had a higher concentration of exosomes in brain tissue (3.73e+10 particles/ml) compared to the control group (0.95e+10 particles/ml, P=0.0030). MicroRNA sequencing revealed distinct expression profiles between the groups. Furthermore, the exo-mCIMT group exhibited significantly higher levels of MAP2 and VEGF expression, along with notable improvements in neurobehavioral outcomes.
Conclusion:
These findings suggest that mCIMT promotes neural recovery through increased exosome and microRNA activity in the brain, which plays an important role in neuronal activity after brain injury.
Insights
Modified constraint-induced movement therapy (mCIMT) enhances brain function after stroke by increasing exosomes and microRNA. This therapy promotes neural recovery and improves motor function through these key biological mechanisms.
Area of Science:
- Neuroscience
- Regenerative Medicine
- Biochemistry
Background:
- Stroke significantly impairs brain function and motor recovery.
- Exosomes and microRNA are implicated in intercellular communication and neural repair.
- Constraint-induced movement therapy (CIMT) is a rehabilitation strategy, but its underlying biological mechanisms require further elucidation.
Purpose of the Study:
- To investigate the effect of modified constraint-induced movement therapy (mCIMT) on exosome and microRNA concentrations in stroke patients and animal models.
- To explore the correlation between mCIMT-induced changes in exosomes and microRNA with functional recovery after stroke.
- To determine if exosome administration can replicate the neuroprotective effects of mCIMT.
Main Methods:
- Analyzed plasma samples from stroke patients undergoing mCIMT versus control groups for cytokines and exosomal microRNAs.
- Utilized a middle cerebral artery occlusion (MCAO) rat model to assess exosome concentration and microRNA profiles in brain tissue after mCIMT.
- Administered exosomes derived from mCIMT-treated or control rats into the brains of MCAO rats to evaluate neurobehavioral and histopathological outcomes.
Main Results:
- mCIMT significantly increased exosome concentration in both stroke patient plasma and rat brain tissue.
- Exosome size in patients correlated with motor function improvement (Fugl-Meyer Motor Function Assessment).
- Exosome administration (exo-mCIMT group) in rats led to increased MAP2 and VEGF expression and improved neurobehavioral outcomes.
Conclusions:
- mCIMT promotes neural recovery post-stroke by enhancing exosome and microRNA activity.
- Increased exosome and microRNA concentrations play a crucial role in neuronal activity and repair after brain injury.
- Exosomes represent a potential therapeutic avenue for stroke recovery.
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