神经损伤与修复

    Is it possible to develop a cerebellar reserve?
  • Figure 1|The panel summarizes the main evidence on cerebellar reserve. 

    The frame described in the present manuscript (Figure 1) is developed on findings mainly obtained in animal studies. It is important to add that also human studies emphasize the cerebellar capacity to compensate the deficits caused by neural injury or degeneration. In fact, cerebellar patients partially compensate damage in case of acute focal lesions – provoked by trauma or stroke – or diffuse neuronal degeneration - due to metabolic, immune-mediated or neurodegenerative ataxias. The compensation may be mediated by the intact cerebellar regions outside the lesioned one, as well as by extracerebellar regions. It occurs in a period named “restorable stage”, associated with the reversal capacity of the intact cerebellar and extra-cerebellar networks, and precedes the exceeding of a neural degeneration threshold (“non-restorable stage”) (Mitoma et al., 2020). Anyway, as described above, numerous cognitive, social, and physical factors, acting as “reserve-builders” are able to modulate the brain capacity to cope with the damage. Nevertheless, studies specifically aimed to analyze the eventual potentiating action of environmental stimulations on cerebellar compensation capacity in humans are still lacking. Starting from the insight provided by Alzheimer’s disease patients, in the last decades the effects of complex environmental stimulations have been studied in a large range of pathologies (neurodegenerative diseases, traumatic injuries, genetic disorders, etc.). Therefore, it is very surprising that similar studies have not been carried out in relation to the cerebellar pathologies, despite the well-known neuroplastic ability of the human cerebellum and the specific suggestions provided by the animal studies. Thus, it could be worthwhile to investigate in the cerebellar patients how previous life experiences may influence the efficacy level of the individual compensation capacity. Moreover, it could be worthwhile to investigate the eventual correlation between foregoing experiences and duration of the period in which treatments may be effective in restoring deficits (restorable stage of the pathology). Such investigations may be really relevant to schedule fine-tuned clinical interventions focused on potentiating individual cerebellar reserve capacities. Similar conclusions have been drawn up by a very recent review on the efficacy of non-invasive cerebellar stimulation (Billeri and Naro, 2021). According to the authors, the successful outcome of such methodology in the treatment of cerebellar dysfunctions of different origin depends on the residual functional reserve of the cerebellum, in total agreement with the perspective we are here proposing.


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  • 发布日期: 2021-12-08  浏览: 463
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