With contemporary lifestyle changes and global aging, it is important yet unknown how stress interacts to post-stroke outcomes. This proposal aims to study the link between the stress-responsive FKBP51-related pathways and neural plasticity after stroke, elucidating FKBP5 gene polymorphisms and blood FKBP51 regulation in relation to brain excitability and functions, understanding the effects of transcranial direct current stimulation, and characterizing brain mechanisms for individualized early rehabilitation after stroke.
Stress is an underestimated risk factor and also a consequence of cardiovascular diseases and stroke. FK506-binding protein 51 (FKBP51) modulates stress responses by acting as a co-chaperone that negatively regulates glucocorticoid receptor (GR) to cortisol binding and nuclear signaling. In an oxygen-glucose deprivation (OGD) model of acute mouse hippocampal slices, FKBP5 deletion reduced ischemic neuronal hyperexcitation, and cathodal electrical stimulation of OGD-injured wild-type decreased FKBP51 levels. However, clinical implications of FKBP5 polymorphisms and FKBP51 regulation in post-stroke outcomes and neuromodulation-induced plasticity are unknown. We aim to assess the link between FKBP5 polymorphisms and blood FKBP51 regulation after stroke, and their relationship with stroke phenotypes, brain connectivity and functional outcomes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
500
The anode and cathode are placed over the ipsilesional and contralesional primary motor cortex (C3 or C4 based on 10-20 system), respectively. The size of the electrode is 5x5 cm.
Taipei Veterans General Hospital
Taipei, Taiwan
RECRUITINGFugl-Meyer Assessment of Upper Extremity, FMA-UE
Motor recovery of upper extremity poststroke
Time frame: Change score from baseline (~10 days poststroke) to 90 days poststroke
Action Research Arm Test, ARAT
Motor function of upper extremity poststroke
Time frame: Change score from baseline (~10 days poststroke) to 90 days poststroke
Fugl-Meyer Assessment of Lower Extremity, FMA-LE
Motor recovery of lower extremity poststroke
Time frame: Change score from baseline (~10 days poststroke) to 90 days poststroke
Perceived Stress Scale-10
Stress level poststroke
Time frame: Change score from baseline (~10 days poststroke) to 90 days poststroke
Protein and gene test
Protein expression poststroke and identifying genotypes of participants
Time frame: Change score from baseline (~10 days poststroke) to 90 days poststroke
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