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London, United Kingdom 2013 9 Rehabilitation and reorganisation after stroke A 9:50 - 10:00 AEROBIC EXERCISES ENHANCE COGNITIVE FUNCTIONS AND BRAIN DE-RIVED NEUROTROPHIC FACTOR AFTER ISCHEMIC STROKE . F. Abd-Allah1, M.S. El Tamawy2, M.H. Darwish3, S.A. Ahmed4, H.A. Khalifa5 Neurology Department, Faculty of medicine, Cairo University., Cairo, EGYPT1,Neurol-ogy Department, Faculty of medicine, Cairo University., Cairo, EGYPT2, Physical therapy department for neuromuscular disorder, Faculty for physical therapy , Cairo University, Cairo, EGYPT3, Neurology Department, Faculty of medicine, Cairo University, Cairo, EGYPT4, 2- Physical therapy department for neuromuscular disorder, Faculty for physical therapy , Cairo University, Cairo, EGYPT5 Background: Brain derived neurotrophic factors (BDNF) have a role in increasing the brain’s resistance to damage and degeneration with aging and enhances long term memory and learning.The current study aims to demonstrate the role of aerobic exercises enhancing cognitive functions and its effect on (BDNF) in post-ischemic stroke patients in the territory of anterior circulation. Methods: Thirty stroke patientswith different degrees of cognitive impairment measured by Aden-brookes’s Cognitive Examination- Revised (ACER) were divided into two equal groups of fif-teen patients each; group 1 (G1) (considered as the control group) were treated by a designed standard physiotherapy program. This program was applied for 25-30 minute per session, three times per week, day after day for successive eight weeks. Group 2 (G2) were treated by the same designed physiotherapy program for “25-30” min. followed by a rest period for about 10- 15 min, then aerobic exercise was done on a bicycle for 40 to 45 min,three times per week for eight weeks. After eight weeks patients in both groups were subjected to reassessment of cog-nitive functions using ACER. Levels of (BDNF) in venous blood sample were assessed before and after the eight weeks of physiotherapy. Results: Comparison of the (ACER) total score post-treatment in (G1) and (G2) showed a statistically significant difference with increased values in the (G2) ; 75.93+/-4.9 and 81.07+/-6.16 respec-tively (p= 0.017). Pre- and post-treatment serum level of BDNF did not show a significant difference in (G1) (P=0.698) but in (G2) there was a high statistical difference (P=0.0001). Pearson rank correlation (r) between the post treatment changes in total score of ACER test and level of serum BDNF in (G2) was 0.53.The result indicated significant positive correlation be-tween improvement in total score of ACER test and increase in serum BDNF level in the study group (P=0.044). Conclusion: Aerobic exercises following an acute ischemic stroke in the territory of anterior circulation sig-nificantly improve cognitive functions measured in this study by (ACER). This improvement is accompanied by an elevation in the serum level of (BDNF). Cerebrovasc Dis 2013; 35 (suppl 3)1-854 99 8 Rehabilitation and reorganisation after stroke A 9:40 - 9:50 Brain reorganization within the motor network supports motor recovery following acute and chronic cerebellar stroke: a fMRI study A. JAILLARD1, M. Hommel2, J.F. Le Bas3, T.A. Zeffiro4 Grenoble University Hospital, Grenoble, FRANCE1,Grenoble University Hospital, Greno-ble, FRANCE2, Grenoble University Hospital, Grenoble, FRANCE3, Massachusetts General Hospital, Boston, USA4 Background: The cerebellar, parietal, primary motor (M1) and premotor (PMC) cortices all participate in sensorimotor (SM) control, with cerebellar processes modulating information re-ceived from frontal and parietal systems. To explore the time course of motor system responses to cerebellar damage, we used fMRI to study the subacute and chronic effects of focal cerebel-lar stroke lesions on brain activity. Methods: We studied 14 patients (46±9years) after their first-ever single cerebellar stroke. The lesions caused ipsilateral limb ataxia lasting one week after stroke onset. Lesion was limit-ed to the territory of the anterior-superior or postero-inferior cerebellar arteries. Patients were matched for age and sex to 14 healthy controls. Motor impairment was assessed using the NI-HSS, Fugl-Meyer Scale, FT Score, Pegboard Test and reaction times. Functional MRI scans were obtained during the acute (6-21 days) and chronic (3-6 months) phases. Participants per-formed a block design sequential finger opposition task (FT). FT contrasts were computed in the first level analysis. At the second level, an ANOVA model assessed the effects of group, time and hand on FT-related activity Results: The patients showed good motor recovery at 6 months and both patients and controls exhibited the canonical motor pattern during FT. For the combined sessions, the right motor cingulum and SMA, the left medial PMC, the left SM1 cortex, the bilateral dorsal PMC, and the left pons were more active in patients than in controls, resulting in higher activity in the fronto-ponto-cerebellar circuit during FT involving the ipsilesional hand. In the affected hemi-sphere, the medial motor system was activated, while the lateral motor system of the contrale-sional hemisphere was activated. There was no difference between session1 and session2 in the patients. Conclusions: Cerebellar lesions can induce brain reorganization from the early phase of stroke, in adapting the balance within the motor network.


Karger_ESC London_2013
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