Noradrenergic modulation of hemiplegia: facilitation and maintenance of recovery.

摘要: This review presents data from laboratory studies and clinical trials indicating the efficacy of "Noradrenergic Strategy" for enhancing recovery after cortical injury. Short-term acute treatment combining Physical Therapy (PT) with drugs increasing noradrenaline (NA) levels enhances hemiplegia in both which also report improved aphasia recovery. Importantly these effects endure even when is initiated months stroke onset. The hypothesized mechanisms included modulation neuronal processes underlying "spontaneous" since reducing NA slow spontaneous effect some change time sensorimotor cortex (SMCx) Drugs levels, including clonidine prazosin, GABA receptor agonists at doses having little early injury, administered to animals or patients "complete recovery" transiently reinstate original symptoms. Reinstatement by prazosin remains unchanged repeated testing over six rat, deficits can be as severe first days suggests "completed" an inaccurate label enduring "fragile" state. transient reinstatement symptoms may useful distinguishing causal corollary relationships between physiological proposed function.