Abstract
Background: Neuroplasticity ensures the improvement of functional status in patients after stroke. The aim of this study was to evaluate the effect of extremely low-frequency electromagnetic field therapy (ELF-EMF) on brain plasticity in the rehabilitation of patients after stroke.Methods: Forty-eight patients were divided into two groups underwent the same rehabilitation program, but in the study group, the patients additionally were exposed to a standard series of 10 ELF-EMF treatments. To determine the level of neuroplasticity, we measured the plasma level of the brain-derived neurotrophic factor (BDNF), the vascular-endothelial growth factor, as well as BDNF mRNA expression. Additionally, we determined the molecule levels for hepatocyte growth factor, stem cell factor, stromal cell-derived factor 1α, nerve growth factor β, and leukemia inhibitory factor, using 5plex cytokine panel in plasma. After 4 weeks, during which patients had undergone neurorehabilitation and neurological examinations, we assessed functional recovery using the Barthel Index, Mini-Mental State Examination (MMSE), Geriatric Depression Scale, National Institutes of Health Stroke Scale (NIHSS), and the modified Rankin Scale (mRS).Results: We observed that ELF-EMF significantly increased growth factors and cytokine levels involved in neuroplasticity, as well as promoted an enhancement of functional recovery in post-stroke patients. Additionally, we presented evidence that these effects could be related to the increase of gene expression on the mRNA level. Moreover, a change of BDNF plasma level was positively correlated with the Barthel Index, MMSE, and negatively correlated with GDS.Conclusion: Extremely low-frequency electromagnetic field therapy improves the effectiveness of rehabilitation of post-stroke patients by improving neuroplasticity processes.
Highlights
Regenerative processes within the brain tissue are limited and regulated by tissue environmental properties, which are affected by changes in the physiology of the organism (Hagg, 2009)
Extremely low-frequency electromagnetic field therapy improves the effectiveness of rehabilitation of post-stroke patients by improving neuroplasticity processes
Because of the crucial role of brain-derived neurotrophic factor (BDNF) participates in the formation of appropriate synaptic connections in the brain, it seems that extremely low-frequency electromagnetic field therapy (ELF-EMF) may serve as a therapeutic treatment to improve the neuroplasticity after stroke
Summary
Regenerative processes within the brain tissue are limited and regulated by tissue environmental properties, which are affected by changes in the physiology of the organism (Hagg, 2009). Neurotrophins are synthesized and secreted by nerve cells in the brain and spinal cord, and the cells of dependent tissue (Hagg, 2009; Lindholm and Saarma, 2010). Compensatory plasticity of the damaged brain is a completely different process from the plasticity occurring in a normally functioning, healthy brain. This process is initiated under critical conditions: in interactions with oedema, inflammation, apoptosis, metabolic disturbances, and fiber degeneration. It starts immediately after an ischaemic event (Liguz-Lecznar and Kossut, 2013). Neuroplasticity consists of strengthening the existing nerve pathways and establishing new connections. The aim of this study was to evaluate the effect of extremely low-frequency electromagnetic field therapy (ELF-EMF) on brain plasticity in the rehabilitation of patients after stroke
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