Genetic variation, stress, and functional outcomes after stroke rehabilitation

中风康复后的遗传变异、压力和功能结果

• 批准号: 9246343
• 负责人: Steven C. Cramer
• 金额: $ 51.32万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-17 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9246343
• 关键词: Activities of Daily Living; Address; Affect; American; Behavior; Behavioral; Biological; Biological Factors; Biological Models; Brain-Derived Neurotrophic Factor; Chronic; Collaborations; Development; Dopamine; Dose; Endocannabinoids; Event; Exposure to; Funding; General Hospitals; Genetic; Genetic Polymorphism; Genetic Predisposition to Disease; Genetic Research; Genetic Variation; Genotype; Health; Human; Human Genetics; Individual; Injury; Intervention; Investigation; Ischemic Stroke; Knowledge; Lead; Life; Longitudinal Studies; Maintenance; Massachusetts; Measures; Molecular; Motor; NR3C2 gene; Neurological status; Outcome; Oxytocin; Patient-Focused Outcomes; Patients; Persons; Phase; Post-Traumatic Stress Disorders; Process; Psychosocial Factor; Questionnaires; Recovery; Rehabilitation therapy; Renin-Angiotensin-Aldosterone System; Research; Serotonin; Stress; Stroke; Supratentorial; Symptoms; System; Therapeutic Studies; Time; Trauma; Variant; Work; acute stress; acute traumatic stress disorder; apolipoprotein E-4; arm; behavioral outcome; depressive symptoms; disability; experience; functional outcomes; gene repair; genetic makeup; geriatric depression; hypothalamic-pituitary-adrenal axis; improved; insight; motor deficit; motor recovery; nerve injury; personalized care; personalized medicine; post stroke; post-traumatic stress; public health relevance; reduce symptoms; rehabilitative care; relating to nervous system; repaired; response; standard of care; stress symptom; stressor; stroke recovery; stroke rehabilitation; stroke survivor; treatment planning; treatment response; Activities of Daily Living; Address; Affect; American; Behavior; Behavioral; Biological; Biological Factors; Biological Models; Brain-Derived Neurotrophic Factor; Chronic; Collaborations; Development; Dopamine; Dose; Endocannabinoids; Event; Exposure to; Funding; General Hospitals; Genetic; Genetic Polymorphism; Genetic Predisposition to Disease; Genetic Research; Genetic Variation; Genotype; Health; Human; Human Genetics; Individual; Injury; Intervention; Investigation; Ischemic Stroke; Knowledge; Lead; Life; Longitudinal Studies; Maintenance; Massachusetts; Measures; Molecular; Motor; NR3C2 gene; Neurological status; Outcome; Oxytocin; Patient-Focused Outcomes; Patients; Persons; Phase; Post-Traumatic Stress Disorders; Process; Psychosocial Factor; Questionnaires; Recovery; Rehabilitation therapy; Renin-Angiotensin-Aldosterone System; Research; Serotonin; Stress; Stroke; Supratentorial; Symptoms; System; Therapeutic Studies; Time; Trauma; Variant; Work; acute stress; acute traumatic stress disorder; apolipoprotein E-4; arm; behavioral outcome; depressive symptoms; disability; experience; functional outcomes; gene repair; genetic makeup; geriatric depression; hypothalamic-pituitary-adrenal axis; improved; insight; motor deficit; motor recovery; nerve injury; personalized care; personalized medicine; post stroke; post-traumatic stress; public health relevance; reduce symptoms; rehabilitative care; relating to nervous system; repaired; response; standard of care; stress symptom; stressor; stroke recovery; stroke rehabilitation; stroke survivor; treatment planning; treatment response

 DESCRIPTION (provided by applicant): Stroke continues to represent the leading cause of long-term disability in Americans. Rehabilitation therapy is provided as standard of care following stroke, as strong evidence supports that it can improve patient outcomes. However, patients show a great deal of variability in their response to post-stroke rehabilitation therapy. While a number of factors have been identified that provide insight into the basis for these inter-subject differences, overall knowledge remains limited. The proposed studies will examine how genetic polymorphisms interact with rehabilitation therapy and with stress to affect treatment-induced recovery after stroke. In this research we build on our prior work and take a unique approach to understanding therapeutic response in stroke survivors. Dr. Holman has addressed the important impact that stress and genetic susceptibilities to stress may have on well-being and health outcomes following trauma. Dr. Cramer has studied stroke recovery and its genetic influences. In collaboration with geneticists in the Center for Human Genetic Research at Massachusetts General Hospital, the team will study how stress and specific genetic factors are related to the response to rehabilitation therapy, and the maintenance of these gains over time. Variability in therapy-induced recovery after stroke is wide. The current studies may provide insight into biological factors underlying this phenomenon, and so may help individualize rehabilitation care.

 描述（由适用提供）：中风继续代表美国人长期残疾的主要原因。康复疗法作为中风后的护理标准提供，因为有力的证据支持它可以改善患者的预后。但是，患者对中风后康复疗法的反应显示出很大的可变性。虽然已经确定了许多因素，这些因素可以洞悉这些受试者间差异的基础，但总体知识仍然有限。拟议的研究将研究遗传多态性如何与康复疗法相互作用，并承受压力，以影响治疗引起的中风后的恢复。在这项研究中，我们以先前的工作为基础，并采取独特的方法来理解中风生存的治疗。霍尔曼博士已经解决了对压力的压力和遗传敏感性可能对创伤后的幸福感和健康结果产生的重要影响。 Cramer博士研究了中风恢复及其遗传影响。与马萨诸塞州综合医院的人类遗传研究中心的遗传学家合作，该团队将研究压力和特定遗传因素如何与对康复治疗的反应以及随着时间的推移维持这些收益有关。治疗引起的中风后恢复的变异性很大。当前的研究可能会提供对这种现象基础的生物因素的见解，因此可能有助于个性化康复护理。