What is the role of brain mechanisms underlying arousal in recovery of motor function after structural brain injuries?

TitleWhat is the role of brain mechanisms underlying arousal in recovery of motor function after structural brain injuries?
Publication TypeJournal Article
Year of Publication2011
AuthorsGoldfine, Andrew M., and Schiff Nicholas D.
JournalCurr Opin Neurol
Volume24
Issue6
Pagination564-9
Date Published2011 Dec
ISSN1473-6551
KeywordsAnimals, Arousal, Behavior, Brain, Brain Injuries, Humans, Motor Activity, Recovery of Function
Abstract

PURPOSE OF REVIEW: Standard neurorehabilitation approaches have limited impact on motor recovery in patients with severe brain injuries. Consideration of the contributions of impaired arousal offers a novel approach to understand and enhance recovery.

RECENT FINDINGS: Animal and human neuroimaging studies are elucidating the neuroanatomical bases of arousal and of arousal regulation, the process by which the cerebrum mobilizes resources. Studies of patients with disorders of consciousness have revealed that recovery of these processes is associated with marked improvements in motor performance. Recent studies have also demonstrated that patients with less severe brain injuries also have impaired arousal, manifesting as diminished sustained attention, fatigue, and apathy. In these less severely injured patients, it is difficult to connect disorders of arousal with motor recovery because of a lack of measures of arousal that are independent of motor function.

SUMMARY: Arousal impairment is common after brain injury and likely plays a significant role in recovery of motor function. A more detailed understanding of this connection will help to develop new therapeutic strategies applicable for a wide range of patients. This requires new tools that continuously and objectively measure arousal in patients with brain injury, to correlate with detailed measures of motor performance and recovery.

DOI10.1097/WCO.0b013e32834cd4f5
Alternate JournalCurr. Opin. Neurol.
PubMed ID22002078
PubMed Central IDPMC3675222
Grant ListHD51912 / HD / NICHD NIH HHS / United States
KL2 RR024997 / RR / NCRR NIH HHS / United States
KL2RR024997 / RR / NCRR NIH HHS / United States
NS067249 / NS / NINDS NIH HHS / United States
R01 HD051912 / HD / NICHD NIH HHS / United States

Weill Cornell Medicine Consortium for the Advanced Study of Brain Injury 520 East 70th Street New York, NY