50 years?
http://www.ncbi.nlm.nih.gov/pubmed/23907078
Abstract
Recovery
of motor function after stroke involves relearning motor skills and is
mediated by neuroplasticity. Recent research has focused on developing
rehabilitation strategies that facilitate such neuroplasticity to
maximize functional outcome poststroke. Although many molecular
signaling pathways are involved, brain-derived neurotrophic factor
(BDNF) has emerged as a key facilitator of neuroplasticity involved in
motor learning and rehabilitation after stroke. Thus, rehabilitation
strategies that optimize BDNF effects on neuroplasticity may be
especially effective for improving motor function poststroke. Two
potential poststroke rehabilitation strategies that consider the
importance of BDNF are the use of aerobic exercise to enhance brain
function and the incorporation of genetic information to individualize
therapy. Converging evidence demonstrates that aerobic exercise
increases BDNF production and consequently enhances learning and memory
processes. Nevertheless, a common genetic variant reduces
activity-dependent secretion of the BDNF protein. Thus, BDNF gene
variation may affect response to motor rehabilitation training and
potentially modulate the effects of aerobic exercise on neuroplasticity.
This perspective article discusses evidence that aerobic exercise
promotes neuroplasticity by increasing BDNF production and considers how
aerobic exercise may facilitate the acquisition and retention of motor
skills for poststroke rehabilitation. Next, the impact of the BDNF gene
val66met polymorphism on motor learning and response to rehabilitation
is explored. It is concluded that the effects of aerobic exercise on
BDNF and motor learning may be better exploited if aerobic exercise is
paired more closely in time with motor training. Additionally,
information about BDNF genotype could provide insight into the type and
magnitude of effects that aerobic exercise may have across individuals
and potentially help guide an individualized prescription of aerobic
exercise to enhance motor rehabilitation poststroke.
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