Métodos de investigação funcional do cérebro e suas implicações na prática da fisioterapia neurológica

Autores

  • Fernando Cesar Iwamoto Marcucci Fisioterapeuta, mestrando em Medicina e Ciências da Saúde/Universidade Estadual de Londrina
  • Samuel Vandresen Filho Fisioterapeuta, mestrando em Neurociências/Universidade Federal de Santa Catarina

DOI:

https://doi.org/10.34024/rnc.2006.v14.8743

Palavras-chave:

Fisioterapia, Imagem por Ressonância Magnética, Tomografia Computadorizada de Emissão, Magnetoencefalografia

Resumo

Os recentes avanços dos métodos de investigação funcional do cérebro têm possibilitado um melhor entendimento das funções corticais, fornecendo uma gama de possibilidades investigativas para a fundamentar a abordagem fisioterápica. A análise destes métodos, como a Imagem por Ressonância Magnética Funcional, a Tomografia por Emissão de Pósitrons, a Magnetoencefalografia e a Estimulação Magnética Transcranial, podem contribuir na elaboração de estratégias terapêuticas, bem como ser uma fonte de esclarecimento sobre os mecanismos neurofisiológicos envolvidos na recuperação neurológica. O objetivo desta revisão é identificar as informações oriundas destes métodos investigativos que são úteis no desenvolvimento da fisioterapia neurológica, principalmente nos aspectos motores dos pacientes após uma lesão cerebral. Através da capacidade de analisar a atividade cerebral, é possível identificar quais áreas do cérebro são ativadas durante determinados comportamentos, localizar áreas lesionadas e entender melhor o processo de recuperação neural, permitindo determinar uma melhor abordagem terapêutica para os pacientes com lesão neurológicas, verificar uma poss ível recuperação ou remodelação através dos tratamentos físicos e quantificar esta melhora, para além dos aspectos clínicos. Para otimizar o potencial terapêutico e o tempo disponível da terapia é essencial conhecer os avanços teóricos e tecnológicos que permitem compreender os mecanismos fisiológicos subjacentes às teorias de recuperação cerebral.

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Referências

Loubinoux I, Carel C, Pariente J, Dechaumont S, Albucher JF, Marque P, et al. Correlation between cerebral reorganization and motor recovery after subcortical infarcts. NeuroImage 2003;20(4):2166-2180.

Schaechter JD. Motor rehabilitation and brain plasticity after hemiparetic stroke. Prog. neurobiol. 2004;73 (1): 61-72. 3. Johansen-Berg H, Dawes H, Guy C, Smith SM, Wade DT, Matthews PM. Correlation between motor improvements and altered fMRI activity after rehabilitative therapy. Brain 2002;125:2731-2742.

Dobkin BH. Strategies for stroke rehabilitation. Lancet Neurol 2004;3:528-536.

Dobkin BH. Editorial Comment Functional MRI: A ptential physiologic indicator for stroke rehabiliation interventions. Stroke 2003;34:26-28.

Hallet M. Transcranial magnetic stimulation and the human brain. Nature 2000; 406:147-150.

Saper CB, Iversen S, Frankowiak. Integration of Sensory and Motor Function: The Association Areas of the Cerebral Cortex and the Cognitive Capabilities of the Brain. In: Kandel ER, Schwartz JH, Jessell TM. Principles of Neural Science. 4th ed. New York: McGraw-Hill; 2000. p.366-80.

Rijntjes M, Weiller C. Recovery of motor and language abilities after stroke: the contribuition of functional imaging. Prog neurobiol. 2002; 66(2):109-122.

Mukamel R, Gelbard H, Arieli A, Fried UHI, Malach R. Coupling between neuronal firing, field potentials, and fmri in human auditory cortex. Science 2005; 309:951-954.

Rossini PM, Pauri F. Neuromagnetic integrated methods tracking human brain mechanisms of sensorimotor areas plastic reorganisation. Brain Res Rev 2000; 33(2-3):131-154.

Foltys H, Krings T, Meister IG, Sparing R, Boroojerdi B, Thron A, et al. Motor representation in patients rapidly recovering after stroke: a functional magnetic resonance imaging and transcranial magnetic stimulation study. Clin Neurophysiol 2003; 114(12):2404-2415.

Koski L, Mernar TJ, Dobkin BH. Immediate and long-term changes in corticomotor output in response to rehabilitation: Correlation with functional improvements in chronic stroke. Neurorehabil Neural Repair 2004; 18(4):230-249.

Rossini PM, Calauti C, Pauri F, Baron JC. Post-stroke plastic reorganization in the adult brain. Lancet Neurol 2003; 2:493-502.

Cirtea MC, Levin MF. Compensatory strategies for reaching in stroke. Brain 2000; 123: 940-953.

Ward NS, Cohen LG. Mechanisms Underlying recovery of motor function after stroke. Arch Neurol 2004; 61(12):1844-1848.

Tombari D, Loubinoux I, Pariente J, Gerdelat A, Albucher JF, Tardy J, et al. A longitudinal fMRI study: in recovery and then in clinically stable sub-cortical stroke patients. NeuroImage 2004; 23(3):827-839.

Hodics T, Cohen LG. Functional neuroimaging in motor recovery after stroke. Top Stroke Rehabil 2005; 12(2): 15-17.

Cohen LG, Roth BJ, Wassermann EM, Topka H, Fuhr P, Schultz J, et al. Magnetic stimulation of the human cerebral cortex, an indicator of reorganization in motor pathways in certain pathological conditions. J Clin Neurophysiol 1991; 8:5665.

Hallet M. Plasticity of the human motor cortex and recovery from stroke. Brain Res Rev 2001; 36(2-3):169-174.

Vulliemoz S, Raineteau O, Jabaudon D. Reaching beyond the midline: why are human brain cross wired? Lancet Neurol 2005; 4:87-99.

Ward NS, Brown MM, Thompson AJ, Frackowiak RSJ. Neural correlates of motor recovery after stroke: a longitudinal fMRI study. Brain 2003; 126(11):2476-2496.

Johansen-Berg H, Matthews PM. Attention to movement modulates activity in sensori-motor areas, including primary motor cortex. Exp Brain Res 2002; 142:1324.

Calautti C, Leroy F, Guincestre JY, Baron JC. Dynamics of motor network overactivation after striatocapsular stroke: a longitudinal PET study using a fixed-performance paradigm. Stroke 2001; 32:25342542.

Marshall RS, Perera GM, Lazar RM, Krakauer JW, Constantine RC, Delapaz RL. Evolution of cortical activation during recovery from corticospinal tract infarction. Stroke. 2000;31:65661.

Hlutík P, Solodkin A, Noll DC, Small SL. Cortical plasticity during three-week motor skill learning. J Clin Neurophysiol 2004; 21(3):180-191.

Liepert J, Bauder H, Miltner WHR, Taub E, Weiller C. Treatment-induced cortical reorganization after stroke in humans. Stroke 2000; 31(6):1210-1216.

Nelles G, Jentzen W, Jueptner M, Müller S, Diener HC. Arm training induced brain plasticity in stroke studied with serial Positron Emission Tomograp NeuroImage 2001; 13:1146-1154.

Calabresi P, Centonze D, Pisani A, Cupini LM, Bernardi G. Synaptic plasticity in the ischaemic brain. Lancet Neurol 2003; 2:622-629.

Dombovy ML. Understanding stroke recovery and rehabilitation: Current and emerging aproaches. Curr Neurol Neurosci Rep 2004; 4:31-35.

Hesse S, Bertelt C, Jahnke MT, Schaffrin A, Baake P, Malezic M, et al. Treadmill training with partial body-weight support compared with physiotherapy in nonambulatory hemiparetic patients. Stroke 1995; 26:976-981.

Miyai I. Locomotor training with partial body weight support in patients with Parkinsons disease and stroke: Its efficacy and neural mechanisms. Geriatr Gerontol Int 2004; 4:S205-S206.

Moseley AM, Stark A, Cameron ID, Pollock A. Treadmill training and body weight support for walking after stroke. In: The Cochrane Library 2005; Oxford: Update Software.

Peurala SH, Tarkka IM, Pitkänen K, Sivenius J. The effectiveness of body weight-supported gait training and floor walking in patients with chronic stroke. Arch Phys Med Rehabil 2005; 86:1557-1564.

Serrien DJ, Strens LH, Cassidy MJ, Thompson AJ, Brown P. Functional significance of the ipsilateral hemisphere during movement of the affected hand after stroke. Exp Neurol 2004; 190(2):425-432.

Liepert J, Graef S, Uhde I, Leidner O, Weiller C. Training-induced changes of motor cortex representations in stroke patients. Acta Neurol Scand 2000; 101(5):321-326.

Van der Lee JH, Wagenaar RC, Lankhorst GJ, Vogelaar TW, Deville WL, Bouter LM. Forced use of the upper extremity in chronic stroke patients: results from a single-blind randomized clinical trial. Stroke 1999; 30:2369

Winstein C, Rose D, Tan S, Lewthwaite R, Chui H, Azen S. A randomized controlled comparison of upper-extremity rehabilitation strategies in acute stroke: a pilot study of immediate and long-term outcomes. Arch Phys Med Rehabil 2004; 85:620628.

Patten C, Lexell J, Brown HE. Weakness and strength training in person with poststroke hemiplegia: Rationale, method and efficacy. J Rehabil Res Dev 2004; 41(3):193-312.

Teixeira-Salmela LF, Olney SJ, Nadeau S, Brouwer B. Muscle strengthening and physical conditioning to reduce impairment and disability in chronic stroke survivors. Arch Phys Med Rehabil 1999; 80:1211-1218.

Badics E, Wittmann A, Rupp M, Stabauer B, Zifko UA. Systematic muscle building exercise in the rehabilitation of stroke patients. Neurorehabil 2002;17: 211-214.

Nadeau SE. A paradigm shift in neurorehabilitation. Lancet Neurol 2002;1: 126-130.

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Publicado

2006-12-31

Como Citar

Marcucci, F. C. I., & Vandresen Filho, S. (2006). Métodos de investigação funcional do cérebro e suas implicações na prática da fisioterapia neurológica. Revista Neurociências, 14(4), 198–203. https://doi.org/10.34024/rnc.2006.v14.8743

Edição

Seção

Revisão de Literatura
Recebido: 2019-02-28
Publicado: 2006-12-31