2023 Fiscal Year Final Research Report

Adaptation of the neuroprotective mechanism by conditioning after cerebral ischemia and its application to stroke rehabilitation

Research Project

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Project/Area Number	20H04039
Research Category	Grant-in-Aid for Scientific Research (B)
Allocation Type	Single-year Grants
Section	一般
Review Section	Basic Section 59010:Rehabilitation science-related
Research Institution	Kagoshima University
Principal Investigator	Sakakima Harutoshi 鹿児島大学, 医歯学域医学系, 教授 (10325780)
Co-Investigator(Kenkyū-buntansha)	丸山征郎鹿児島大学, 医歯学総合研究科, 客員研究員 (20082282) 前島洋北海道大学, 保健科学研究院, 教授 (60314746) 菊池清志久留米大学, 医学部, 准教授 (60404539) 大塚章太郎鹿児島大学, 医歯学総合研究科, 特任助教 (80849901)
Project Period (FY)	2020-04-01 – 2024-03-31
Keywords	運動 / 遠隔虚血コンディショニング / 脳神経保護 / リハビリテーション / 機能回復 / 神経炎症 / 漢方薬 / 脳梗塞
Outline of Final Research Achievements	In this research project, we investigated the mechanisms of neuroprotection by pre-conditioning exercise (PE) and remote ischemic conditioning (RIC). Preconditioning exercise-induced neuroprotective potential may be lost shortly after exercise cessation. The duration of reperfusion may affect the brain protective effect. Notably, RIPerC with a reperfusion time of approximately 10 min exerts its neuroprotective effects via an anti-apoptotic mechanism. Ninjin’yoeito (NYT) in combination with exercise provides neuroprotective effects and improves sensorimotor function by stimulating NGF/TrkA and BDNF/TrkB, and by activating the Akt pathway in ischemic stroke of rats. Low-intensity motor balance and coordination exercise prevented age-related cognitive decline in the early stage of AD progression, possibly through the suppression of hippocampal Aβ deposition, neuronal loss, oxidative stress, and neuroinflammation, including reduced M1 and A1 phenotypes microglia and astrocytes.
Free Research Field	リハビリテーション医学
Academic Significance and Societal Importance of the Research Achievements	脳梗塞発症前・後のPE、RIC、運動療法による脳神経保護メカニズムや認知・機能回復促進効果、リハビリテ-ション処方に重要である効果的な負荷量、頻度、時間などに関しては十分解明されていない。また、運動習慣の有無による脳保護効果、認知機能に及ぼす影響、運動機能改善効果、RICとPEの併用効果、薬剤と運動療法の併用効果などに関しても十分解明されていない。従って、本研究成果の学術的意義や社会的意義は、運動や遠隔虚血コンディショニングによる神経保護メカニズムを解明し、脳卒中リハビリテーションや認知症に対する予防リハビリテーションの科学的根拠を確立したことである。