%0 Journal Article
%T Autologous Bone Marrow Mononuclear Cells Intrathecal Transplantation in Chronic Stroke
%A Alok Sharma
%A Hemangi Sane
%A Nandini Gokulchandran
%A Dipti Khopkar
%A Amruta Paranjape
%A Jyothi Sundaram
%A Sushant Gandhi
%A Prerna Badhe
%J Stroke Research and Treatment
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/234095
%X Cell therapy is being widely explored in the management of stroke and has demonstrated great potential. It has been shown to assist in the remodeling of the central nervous system by inducing neurorestorative effect through the process of angiogenesis, neurogenesis, and reduction of glial scar formation. In this study, the effect of intrathecal administration of autologous bone marrow mononuclear cells (BMMNCs) is analyzed on the recovery process of patients with chronic stroke. 24 patients diagnosed with chronic stroke were administered cell therapy, followed by multidisciplinary neurorehabilitation. They were assessed on functional independence measure (FIM) objectively, along with assessment of standing and walking balance, ambulation, and hand functions. Out of 24 patients, 12 improved in ambulation, 10 in hand functions, 6 in standing balance, and 9 in walking balance. Further factor analysis was done. Patients of the younger groups showed higher percentage of improvement in all the areas. Patients who underwent cell therapy within 2 years after the stroke showed better changes. Ischemic type of stroke had better recovery than the hemorrhagic stroke. This study demonstrates the potential of autologous BMMNCs intrathecal transplantation in improving the prognosis of functional recovery in chronic stage of stroke. Further clinical trials are recommended. This trial is registered with NCT02065778. 1. Introduction Recovery after stroke is quite heterogeneous, as it is determined by the site and extent of lesion. The process of recovery occurs through a combination of spontaneous and learning-dependent processes. These include restitution (restoring the functional status of the injured neural tissue), substitution (reorganization of the spared pathways in order to relearn the lost functions), and compensation (reducing the disparity between the impaired function of the patient and the environmental demands on the patient) [1]. The process by which the above events occur includes angiogenesis, neurogenesis, and synaptic plasticity [2]. The overall outcome of these patients improves with rapid diagnosis, early preventive treatment, early recognition of complications, and mobilization [3]. After a central nervous system (CNS) insult like stroke, the quiescent stem cells present in the bone marrow show increased mobilization and migration from their resident bone marrow into the blood circulation as a result of cytokine production from the CNS. Thus the recruitment of bone marrow cells in the injured area of the brain is amplified. This process is the
%U http://www.hindawi.com/journals/srt/2014/234095/