tailieunhanh - The Clinical Science of Neurologic Rehabilitation

he Second Edition of this single-authored volume integrates multiple disciplines of basic and clinical research to help clinicians further develop the best possible care for the rehabilitation of patients with neurologic diseases. From the readable descriptions of the structures and functions of pathways for movement and cognition, the reader comes to understand the potential for training induced, pharmacologic, | The Clinical Science of Neurologic Rehabilitation Second Edition BRUCE H. DOBKIN . OXFORD UNIVERSITY PRESS Contents Part I. Neuroscientific Foundations for Rehabilitation 1. ORGANIZATIONAL PLASTICITY IN SENSORIMOTOR AND COGNITIVE NETWORKS 3 SENSORIMOTOR NETWORKS 4 Overview of Motor Control Cortical Motor Networks Somatosensory Cortical Networks Pyramidal Tract Projections Subcortical Systems Brain Stem Pathways Spinal Sensorimotor Activity STUDIES OF REPRESENTATIONAL PLASTICITY 39 Motor Maps Sensory Maps BASIC MECHANISMS OF SYNAPTIC PLASTICITY 44 Hebbian Plasticity Cortical Ensemble Activity Long-Term Potentiation and Depression Molecular Mechanisms Growth of Dendritic Spines Neurotrophins Neuromodulators COGNITIVE NETWORKS 52 Overview of the Organization of Cognition Explicit and Implicit Memory Network Working Memory and Executive Function Network Emotional Regulatory Network Spatial Awareness Network Language Network SUMMARY 64 2. BIOLOGIC ADAPTATIONS AND NEURAL REPAIR 76 TERMS FOR IMPROVEMENT AFTER INJURY 79 Compensation Restitution and Substitution Impairment and Disability INTRINSIC BIOLOGIC ADAPTATIONS 81 Spontaneous Gains Activity in Spared Pathways Sensorimotor Representational Plasticity Spasticity and the Upper Motor Neuron Syndrome Synaptogenesis Denervation Hypersensitivity Axon Regeneration and Sprouting Axon Conduction Growth Factors Neurogenesis POTENTIAL MANIPULATIONS FOR NEURAL REPAIR 99 Activity-Dependent Changes at Synapses Stimulate Axonal Regeneration Deploy Neurotrophins Cell Replacement Pharmacologic Potentiation MUSCLE PLASTICITY 113 Exercise Atrophy Regeneration Combined Approaches EXPERIMENTAL INTERVENTIONS FOR REPAIR OF SPINAL CORD INJURY 118 Prevent Cell Death Increase Axonal Regeneration Remyelination Other Transplantation Strategies Retraining the Spinal Motor Pools ix x Contents RELEVANCE OF ANIMAL MODELS OF REPAIR TO CLINICAL TRIALS 129 Eight Potential Pitfalls of Animal Models SUMMARY 134 3. FUNCTIONAL NEUROIMAGING OF RECOVERY .