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

 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（由申请人提供）：中风仍然是美国人长期残疾的主要原因，康复治疗作为中风后的护理标准提供，因为强有力的证据表明它可以改善患者的预后。尽管已经确定了许多因素来深入了解这些受试者间差异的基础，但拟议的研究将探讨遗传多态性如何与康复相互作用。治疗和压力在这项研究中，我们以之前的工作为基础，采取了一种独特的方法来了解中风幸存者的治疗反应，解决了压力和对压力的遗传敏感性可能对健康产生的重要影响。克莱默博士与马萨诸塞州总医院人类遗传研究中心的遗传学家合作，研究了中风恢复及其遗传影响。对康复治疗的反应以及这些的维持随着时间的推移，治疗引起的康复效果存在很大差异，目前的研究可能有助于深入了解这种现象背后的生物学因素，因此可能有助于个体化康复治疗。