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Induced neuroplasticity via transcranial magnetic stimulation in subjects with ischemic stroke


Author: Gasnaş Alexandru
Degree:doctor of medicine
Speciality: 14.00.13 - Neurology
Year:2019
Scientific adviser: Stanislav Groppa
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

Term of presenting of the thesis 20 November, 2019

Abstract

Adobe PDF document1.06 Mb / in romanian

Thesis

CZU 616.831-005.4:615.847.8(043.2)

Adobe PDF document 3.89 Mb / in romanian
167 pages


Keywords

Stroke, transcranial magnetic stimulation, neuroplasticity, polymorphism of the BDNF (Brain-derived neutrophic factor) gene

Summary

Structure of the thesis: The thesis consists of the following compartments: introduction, 4 chapters, general conclusions, practical recommendations, bibliography from 211 titles and 8 annexes. The thesis is exposed on 108 text pages and is illustrated with 61 figures and 9 tables.

The results are published in 21 scientific papers.

Field of study: neurology, clinical rehabilitation.

Purpose of the study: The study of the peculiarities of cerebral plasticity in patients with ischemic stroke during the acute phase and the investigation of the rs6265 polymorphism of the BDNF human gene under the influence of transcranial magnetic stimulation (SMT).

Objectives of the study: 1) The assessment of the clinical-evolutionary features of patients with ischemic stroke during the acute phase. 2) Appreciation of the rs6265 polymorphism of patients with ischemic stroke by investigating the human BDNF gene. 3) The evaluation of the efficacy of transcranial magnetic stimulation in the rehabilitation of patients with ischemic stroke during the acute phase. 4) The analysis of correlations between transcranial magnetic stimulation results and the rs6265 polymorphism of the BDNF human gene in the rehabilitation of patients with acute ischemic stroke. 5) The highlighting of the ideal candidate pattern for Transcranial Magnetic Stimulation in rehabilitation after ischemic stroke.

Scientific novelty and originality: For the first time, BDNF human gene expression was investigated in patients with stroke during the acute phase, and the efficacy of SMT in their rehabilitation was assessed.

Solved scientific problem consists in elucidating the clinical evolution of patients who suffered an ischemic stroke based on their genetic polymorphism and the influence of SMT, with further elaboration of predictive criteria for the ideal candidate for SMT in order to optimize the therapeutic management of patients with ischemic stroke.

Theoretical significance consists in evaluating the clinical-evolutionary features of patients with ischemic stroke during the acute phase. The study brought additional knowledge on the assessment of factors and preconditions with important role in the rehabilitation of patients after ischemic stroke, facilitating an individualized prognosis and probability of recovery. Application value: deducted predictive models will be applied in medical practice and they emphasize the importance of very careful assessment and monitoring of stroke patients, where multiple prediction factors are aggregated.

Implementation of scientific results: Optimizing the early identification process of the ideal SMT candidate and adding this complementary method of treatment in the acute and subacute phase of stroke in the institutional and national guidelines and protocols.