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Ontogenetic Therapeutic Approach for Alzheimer Disease: Toward a Neuroplasticity principled  Rehabilitation Model

Valentin Bragin1, Ilya Bragin1,2,3

1. Stress Relief and Memory Training Center, NY, United States of America

2. St. Lukes University Health Network, PA, United States of America

3. Department of Neurology, Lewis Katz School of Medicine at Temple University, PA, United States of America

Oral presentation at international conference on Movement and Cognition at Harvard University’s School of Medicine July 27-29, 2018 in Boston, 2018.

Recent scientific advances in our understanding of the pathogenesis of Alzheimer disease (AD) suggest that an integrative rehabilitation model is a legitimate disease-modifying therapeutic option. It is based on actively utilizing clinically important modifiable factors. The goal of rehabilitation in chronic neurodegenerative disease as AD is to prevent physical and cognitive decline of people with dementia and to enable them to maintain function based on brain and body reserves for the longest period of time.  This model challenges current rehabilitative assumptions, which separate physical from cognitive aspects of rehabilitation. We suggest one novel solution, based on using our ontogenic pathways of early development for the activation of brain and body in people with AD. The cortical homunculus map is a visual representation of different part of the body in the sensory and motor cortex (Penfield W. et al, 1938). The cortical homunculus is a result of our ontogeny in the context of our sensory – motor activities. Mimicry, laryngeal and tongue muscles activities come first in development occupy much more space in the sensory-motor cortex and are relatively preserved in dementia. Activities of the legs come later and occupy less space in the sensory-motor cortex. During aging and in dementia, gait is affected first and could be an early sign of dementia.

Our rehabilitation model for AD is based on the systemic activation of muscle groups following our natural ontogeny course: hand and sounds activities – first and leg – second (Bragin V., 2007). Similarly, in our rehabilitation sessions, physical activities must be first followed by cognitive training. The efficiency of rehabilitation is evaluated by our computerized program and is based on measurement of motor speed and reaction time for different mental activities. We demonstrated the delay in the progression of cognitive deficit in demented, depressed and medically ill seniors in outpatient settings for 72 months of therapy (Bragin et al., 2014).

In conclusion, this working rehabilitation model is effective, flexible, and suitable for outpatient memory clinics, homes, rehabilitation facilities and nursing homes. This novel approach taking into account ontogenesis can be utilized in various rehabilitation programs.

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