Year : 2014 | Volume
: 140 | Issue : 5 | Page : 698--699
Clinical recovery from CNS damag
Tapas K Banerjee
Department of Neurology, National Neurosciences Centre, Kolkata 700 094, West Bengal, India
Tapas K Banerjee
Department of Neurology, National Neurosciences Centre, Kolkata 700 094, West Bengal
|How to cite this article:|
Banerjee TK. Clinical recovery from CNS damag.Indian J Med Res 2014;140:698-699
|How to cite this URL:|
Banerjee TK. Clinical recovery from CNS damag. Indian J Med Res [serial online] 2014 [cited 2020 Feb 24 ];140:698-699
Available from: http://www.ijmr.org.in/text.asp?2014/140/5/698/149004
Clinical recovery from CNS damag , H. Naritomi, B.W. Krieger, editors (Karger, Basel, Switzerland) 2013. 152 pages. Price: US $ 233.00 / CHF 198.00
Neuronal recovery after acute cerebral injury (due to stroke, trauma, hypoxia, etc.) is a fascinating subject but our knowledge in this area is still limited. However, over the past decade there has been an enormous progress in neuroimaging and electro diagnostic medicine, which has thrown light on the scientific underpinnings of neuronal recovery. This book is an informative compilation on the same lines and is the 32 nd volume of the series Frontiere of Neurology and Neuroscience. The book is divided into 16 chapters each dealing with an important facet of cerebral neuronal recovery. All the chapters are extremely informative and written in a compelling and lucid style. The Figures are very relevant and illustrative.
Post-stroke condition is the prototype to study the mechanism of neural restoration and the first five chapters of this book comprehensively outline the mechanisms of post-stroke cerebral recovery determined by utilizing sophisticated non-invasive advanced neuro-imaging techniques [functional MRI (fMRI), diffusion tensor imaging (DTI)] along with focal transcranial magnetic stimulation (TMS). The TMS is an interventional method that transiently interferes with the ongoing neuronal activity in the stimulated focal cerebral area and helps to probe the functional relevance of a change in regional activity as revealed by fMRI. The ancillary investigational tools include EEG, magneto-encephalography, transcranial direct current stimulation and so on. Through all these sophisticated techniques it has been determined that recovery after CNS damage occurs not only by functional cortical reorganization in ipsi- and contralateral hemispheres (neuroplasticity) but also by structural alterations with axonal sprouting and regeneration. Recent evidence has shown that neurogenesis also takes place in humans contributing to cerebral repair.
Chapters 6, 7 and 8 discuss the research being conducted with stem cell therapy in neuronal rejuvenation. Studies on hematopoietic, mesenchymal and embryonic-like stem cells are under way. There is a therapeutic potential for bone marrow stromal cell (BMSC) transplantation and direct intra-cerebral injection seems to be the most effective method of delivery. Although stem cell therapy could be the future for complete neuronal restoration, there is still a substantial gap in translational laboratory-to-clinic understanding of this form of therapy.
Chapter 9 describes a wide range of medications that are under investigation, aimed at enhancing neuronal recovery. Attempts to synthesize pharmaceuticals that stimulate plasticity or regeneration or else neutralize axonal growth is ongoing.
Chapter 11 presents brain-computer interface (BCI) as a useful tool for motor functional recovery. The changes in brain activity registered through EEG are fed to the computer and then in turn fed back to the subject as visual input. Thus BCI allows brain activity to facilitate a learning process that improves rehabilitation. Chapter 12 deals with the influence of ipsilateral paralesional areas and the contralateral hemisphere in the recovery of post-stroke aphasia. Based on the knowledge regarding post-stroke cortical reorganization, a new paradigm for post-stroke sensorimotor and cognitive rehabilitation can be designed. This book discusses about non-invasive repetitive TMS (rTMS) therapy and about constraint-induced movement therapy to modulate cortical excitability to facilitate rehabilitation.
Chapter 14 deals with therapeutic hypothermia on neuronal regeneration after cerebral ischaemia while chapter 15 talks about the future prospect of high voltage electric potentials to enhance brain-derived neurotrophic factors (BDNF) aimed at improving cognition and inducing tolerance to cerebral infarction.
In the last chapter, the role of the free radical scavenger, edaravone in the prevention of post-stroke disuse muscle atrophy has been described. However, the provided data are of a single study showing the benefit of edaravone. In fact, this drug needs further studies before its beneficial role in stroke can be established.
On the whole, this is a valuable book that deals with a fascinating subject little known to clinicians. This book is recommended for neurologists, neurosurgeons, physiatrists and basic neuroscientists.