Deﬁcit of Inhibition as a Marker of Neuroplasticity (DEFINE Study) in Rehabilitation: A Longitudinal Cohort Study Protocol

Frontiers in Neurology, 2021 · DOI: 10.3389/fneur.2021.695406 · Published: August 9, 2021

Neurology Neurorehabilitation Bioinformatics

Simple Explanation

Brain plasticity, the brain's ability to change, is crucial for recovery after nervous system injuries. Injuries can disrupt the balance between brain inhibition and excitability, which are important for neuroplasticity. Understanding biomarkers related to functional disability can help optimize and personalize rehabilitation treatments. This study aims to identify biomarkers that represent the imbalance in cerebral activity and its impact on rehabilitation. The researchers aim to understand the relationship between biomarkers and functional impairment related to disability, regardless of the cause. This study is designed to understand brain plasticity in the context of rehabilitation, where there is limited knowledge about the mechanisms involved in the balance between neural inhibition and excitability. Also, the current literature has had a low impact on rehabilitation practice.

Study Duration

Not specified

Participants

500 subjects (400 patients with stroke, spinal cord injury, limb amputation, or osteoarthritis and 100 healthy controls)

Evidence Level

Cohort study protocol

Key Findings

1
The study aims to identify neurophysiological biomarkers, particularly markers of inhibition, that have relevance in the scientific and therapeutic improvement in rehabilitation.
2
The study expects to build a better understanding of brain modification associated with prosthesis adaptation and movement adaptation assisted technologies in patients with stroke and spinal cord injury.
3
The study intends to identify biomarkers as substitute, prognostic, and predictive, which indicate functional recovery regardless of rehabilitation therapy.

Research Summary

This cohort study will follow four groups (stroke, spinal cord injury, limb amputation, and osteoarthritis) to understand the neuroplasticity mechanisms involved in motor rehabilitation. The study will use neurophysiological assessments including transcranial magnetic stimulation, electroencephalography, functional near-infrared spectroscopy, and magnetic resonance imaging to assess plasticity on the motor cortex before and after rehabilitation. The study aims to understand the relationship between brain plasticity biomarkers and functional disability related to central and peripheral neural injury, and to identify transdiagnostic markers linked with plasticity in disability and pain regardless of the diagnosis label.

Practical Implications

Effective Approaches

Understanding brain plasticity in the context of rehabilitation allows for more effective approaches and provides screening evaluations of current rehabilitation techniques.

Personalized Rehabilitation

Identifying predictive biomarkers of functional recovery will allow the individualization of treatment and potentialize future insights about the new approaches of rehabilitation.

Posology of Treatment

The identification of markers to measure functional recovery will allow for feasible and powered studies to be performed in an extensive and consistent manner, answering questions such as the posology of the treatment.

Study Limitations

1
The results will not provide a causal relationship between neurophysiological markers and functional and clinical outcomes.
2
The study may be underpowered, as there are four groups of intervention, and the differences between severities of conditions could lead to different dropout rates.
3
The study may lack generalizability, as the study will be performed in only one center.

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