http://nro.sagepub.com/content/20/1/56.abstract?etoc
- 1Department of Neurology, Cologne University Hospital, Cologne, Germany
- 2Max Planck Institute for Neurological Research, Cologne, Germany
- 3Sobell Department of Motor Neuroscience, UCL Institute of Neurology, London, UK
- 4The National Hospital for Neurology and Neurosurgery, London, UK
- Christian Grefkes, Department of Neurology, Cologne University Hospital, Kerpener Strasse 62, Cologne 50624, Germany. Email: christian.grefkes@uk-koeln.de
Abstract
The brain has an intrinsic capacity to
compensate for structural damage through reorganizing of surviving
networks. These
processes are fundamental for recovery of function
after many forms of brain injury, including stroke. Functional
neuroimaging
techniques have allowed the investigation of these
processes in vivo. Here, we review key advances over the past two
decades
that have shed light on the neural mechanisms
enabling recovery of motor function after stroke. We first provide an
overview
on invasive stroke models in non-human primates
that provided insights into lesion-induced changes in the cortical
representations
of the upper limb. We then present key findings
from neuroimaging studies in human stroke patients, which suggest that
the
role of contralesional motor hemisphere in
supporting recovered function depends on factors such as time since
stroke, lesion
location and anatomical region. More recently,
research has been directed at understanding how surviving brain regions
influence
one another during movement. It appears that it is
not only the corticospinal tract but also brainstem pathways and
interhemispheric
connections that affect cortical reorganization
patterns and functional recovery. In summary, neuroimaging opens the way
for
greater understanding of the mechanisms of recovery
and potentially improves our ability to deliver effective restorative
therapy.
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