IMR Press / FBL / Volume 26 / Issue 11 / DOI: 10.52586/5020
Open Access Review
Non-invasive, non-pharmacological/bio-technological interventions towards neurorestoration upshot after ischemic stroke, in adults—systematic, synthetic, literature review
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1 Physical and Rehabilitation Medicine Department, Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
2 Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania
3 Specific Disciplines Department, Faculty of Midwifes and Nursing, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
4 Medical-Surgical and Prophylactic Disciplines Department - Medical Rehabilitation, Recovery and Medical Physical Culture Discipline, Faculty of Medicine, University “Titu Maiorescu”, 040051 Bucharest, Romania
5 Physical and Rehabilitation Medicine & Balneology Clinic Division – The Neuro-Rehabilitation Compartment, Teaching Emergency Hospital of the Ilfov County, 22104 Bucharest, Romania
6 Politehnica University of Bucharest, Computer Science Department, 060042 Bucharest, Romania
7 Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700454 Iasi, Romania
*Correspondence: gelu.onose@umfcd.ro (Gelu Onose); firancarmen@yahoo.com (Florentina Carmen Firan)
Front. Biosci. (Landmark Ed) 2021, 26(11), 1204–1239; https://doi.org/10.52586/5020
Submitted: 23 July 2021 | Revised: 2 October 2021 | Accepted: 20 October 2021 | Published: 30 November 2021
Copyright: © 2021 The Author(s). Published by BRI.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

Considering its marked life-threatening and (not seldom: severe and/or permanent) disabling, potential, plus the overall medico-psycho-socio-economic tough burden it represents for the affected persons, their families and the community, the cerebrovascular accident (CVA)—including with the, by far more frequent, ischemic type—is subject to considerable scientific research efforts that aim (if possible) at eliminating the stroke induced lesions, and consist, as well, in ambitious—but still poorly transferable into medical practice—goals such as brain neuroregeneration and/or repair, within related corollary/upshot of neurorestoration. We have conducted, in this respect, a systematic and synthetic literature review, following the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” concept. Accordingly, we have interrogated five internationally renowned medical data bases: Elsevier, NCBI/PubMed, NCBI/PMC, PEDro, and ISI Web of Knowledge/Science (the last one to check whether the initially identified articles are published in ISI indexed journals), based on a large (details in the body text) number of most appropriate, to our knowledge, key word combinations/“syntaxes”—used contextually—and subsequently fulfilling the related, on five steps, filtering/selection methodology. We have thereby selected 114 fully eligible (of which contributive: 83—see further) papers; at the same time, additionally, we have enhanced our documentation—basically, but not exclusively, for the introductive part of this work (see further)—with bibliographic resources, overall connected to our subject, identified in the literature within a non-standardized search. It appears that the opportunity window for morph-functional recovery after stroke is larger than previously thought, actually being considered that brain neurorestoration/repair could occur, and therefore be expected, in later stages than in earlier ones, although, in this context, the number of cases possibly benefitting (for instance after physical and/or cognitive rehabilitation—including with magnetic or direct current transcranial stimulation) is quite small and with more or less conflicting, related outcomes, in the literature. Moreover, applying especially high intense, solicitating, rehabilitation interventions, in early stages post (including ischemic) stroke could even worsen the functional evolution. Accordingly, for clarifications and validation of more unitary points of view, continuing and boosting research efforts in this complex, interdisciplinary domain, is necessary. Until finding (if ever) effective modalities to cure the lesions of the central nervous system (CNS)—including post ischemic stroke—it is reasonable and recommendable—based on rigorous methodologies—the avail of combined ways: physiatric, pharmacologic, possibly also bio-technologic. On a different note, but however connected to our subject: periodic related systematic, synthetic literature reviews reappraisals are warranted and welcome.

Keywords
Non-invasive
Non-pharmacological/biotechnological interventions
Neurorestoration
Neuroregeneration
Brain repair
Ischemic stroke
Adults
Systematic
Synthetic
Literature review
Figures
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