scholarly journals Maladaptive Plasticity for Motor Recovery after Stroke: Mechanisms and Approaches

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Naoyuki Takeuchi ◽  
Shin-Ichi Izumi
Keyword(s):  
Motor Function ◽  
Neural Plasticity ◽  
Motor Pattern ◽  
Movement Pattern ◽  
Competitive Interaction ◽  
Motor Recovery ◽  
Cortical Reorganization ◽  
Stroke Patients ◽  
Compensatory Movement ◽  
Maladaptive Plasticity

Many studies in human and animal models have shown that neural plasticity compensates for the loss of motor function after stroke. However, neural plasticity concerning compensatory movement, activated ipsilateral motor projections and competitive interaction after stroke contributes to maladaptive plasticity, which negatively affects motor recovery. Compensatory movement on the less-affected side helps to perform self-sustaining activity but also creates an inappropriate movement pattern and ultimately limits the normal motor pattern. The activated ipsilateral motor projections after stroke are unable to sufficiently support the disruption of the corticospinal motor projections and induce the abnormal movement linked to poor motor ability. The competitive interaction between both hemispheres induces abnormal interhemispheric inhibition that weakens motor function in stroke patients. Moreover, widespread disinhibition increases the risk of competitive interaction between the hand and the proximal arm, which results in an incomplete motor recovery. To minimize this maladaptive plasticity, rehabilitation programs should be selected according to the motor impairment of stroke patients. Noninvasive brain stimulation might also be useful for correcting maladaptive plasticity after stroke. Here, we review the underlying mechanisms of maladaptive plasticity after stroke and propose rehabilitation approaches for appropriate cortical reorganization.

scholarly journals Noninvasive Brain Stimulation for Motor Recovery after Stroke: Mechanisms and Future Views

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Naoyuki Takeuchi ◽  
Shin-Ichi Izumi
Keyword(s):  
Brain Stimulation ◽  
Neural Plasticity ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Motor Recovery ◽  
Cortical Reorganization ◽  
Motor Deficits ◽  
Stroke Patients ◽  
Noninvasive Brain Stimulation ◽  
Interhemispheric Competition ◽  
Underlying Mechanisms

Repetitive transcranial magnetic stimulation and transcranial direct current stimulation are noninvasive brain stimulation (NIBS) techniques that can alter excitability of the human cortex. Considering the interhemispheric competition occurring after stroke, improvement in motor deficits can be achieved by increasing the excitability of the affected hemisphere or decreasing the excitability of the unaffected hemisphere. Many reports have shown that NIBS application improves motor function in stroke patients by using their physiological peculiarity. For continuous motor improvement, it is important to impart additional motor training while NIBS modulates the neural network between both hemispheres and remodels the disturbed network in the affected hemisphere. NIBS can be an adjuvant therapy for developed neurorehabilitation strategies for stroke patients. Moreover, recent studies have reported that bilateral NIBS can more effectively facilitate neural plasticity and induce motor recovery after stroke. However, the best NIBS pattern has not been established, and clinicians should select the type of NIBS by considering the NIBS mechanism. Here, we review the underlying mechanisms and future views of NIBS therapy and propose rehabilitation approaches for appropriate cortical reorganization.

The effect and optimal parameters of repetitive transcranial magnetic stimulation on motor recovery in stroke patients: a systematic review and meta-analysis of randomized controlled trials

2019 ◽  
Vol 33 (5) ◽  
pp. 847-864 ◽  
Author(s):  
Huifang Xiang ◽  
Jing Sun ◽  
Xiang Tang ◽  
Kebin Zeng ◽  
Xiushu Wu
Keyword(s):  
Motor Function ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Motor Recovery ◽  
Controlled Trials ◽  
Optimal Parameters ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Stimulation Parameters ◽  
Stroke Population

Objective: The primary aim of this meta-analysis was to evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on limb movement recovery post-stroke and cortex excitability, to explore the optimal parameters of rTMS and suitable stroke population. Second, adverse events were also included. Data sources: The databases of PubMed, EBSCO, MEDLINE, the Cochrane Central Register of Controlled Trials, EBM Reviews-Cochrane Database, the Chinese National Knowledge Infrastructure, and the Chinese Science and Technology Journals Database were searched for randomized controlled trials exploring the effects of rTMS on limb motor function recovery post-stroke before December 2018. Review methods: The effect sizes of rTMS on limb motor recovery, the effect size of rTMS stimulation parameters, and different stroke population were summarized by calculating the standardized mean difference (SMD) and the 95% confidence interval using fixed/random effect models as appropriate. Results: For the motor function assessment, 42 eligible studies involving 1168 stroke patients were identified. The summary effect size indicated that rTMS had positive effects on limb motor recovery (SMD = 0.50, P < 0.00001) and activities of daily living (SMD = 0.82, P < 0.00001), and motor-evoked potentials of the stimulated hemisphere differed according to the stimulation frequency, that is, the high-frequency group (SMD = 0.57, P = 0.0006), except the low-frequency group (SMD = –0.27, P = 0.05). No significant differences were observed among the stimulation parameter subgroups except for the sessions subgroup ( P = 0.02). Only 10 included articles reported transient mild discomfort after rTMS. Conclusions: rTMS promoted the recovery of limb motor function and changed the cortex excitability. rTMS may be better for early and pure subcortical stroke patients. Regarding different stimulation parameters, the number of stimulation sessions has an impact on the effect of rTMS.

Cortical reorganization associated with motor recovery in hemiparetic stroke patients

Neuroreport ◽  
2003 ◽  
Vol 14 (10) ◽  
pp. 1305-1310 ◽  
Author(s):  
Sung Ho Jang ◽  
Yun-Hee Kim ◽  
Sang-Hyun Cho ◽  
Yongmin Chang ◽  
Zee In Lee ◽  
...  
Keyword(s):  
Motor Recovery ◽  
Cortical Reorganization ◽  
Stroke Patients ◽  
Hemiparetic Stroke

Cortical reorganization associated with motor recovery in hemiparetic stroke patients

Neuroreport ◽  
2003 ◽  
Vol 14 (10) ◽  
pp. 1305-1310 ◽  
Author(s):  
Sung Ho Jang ◽  
Yun-Hee Kim ◽  
Sang-Hyun Cho ◽  
Yongmin Chang ◽  
Zee In Lee ◽  
...  
Keyword(s):  
Motor Recovery ◽  
Cortical Reorganization ◽  
Stroke Patients ◽  
Hemiparetic Stroke

scholarly journals Motor Recovery and Cortical Reorganization after Constraint-Induced Movement Therapy in Stroke Patients: A Preliminary Study

2002 ◽  
Vol 16 (4) ◽  
pp. 326-338 ◽  
Author(s):  
Judith D. Schaechter ◽  
Eduard Kraft ◽  
Timothy S. Hilliard ◽  
Rick M. Dijkhuizen ◽  
Thomas Benner ◽  
...  
Keyword(s):  
Movement Therapy ◽  
Motor Recovery ◽  
Cortical Reorganization ◽  
Stroke Patients ◽  
Constraint Induced Movement Therapy ◽  
Preliminary Study

CRMP2-binding compound, edonerpic maleate, accelerates motor function recovery from brain damage

Science ◽  
2018 ◽  
Vol 360 (6384) ◽  
pp. 50-57 ◽  
Author(s):  
Hiroki Abe ◽  
Susumu Jitsuki ◽  
Waki Nakajima ◽  
Yumi Murata ◽  
Aoi Jitsuki-Takahashi ◽  
...  
Keyword(s):  
Brain Damage ◽  
Motor Function ◽  
Neural Plasticity ◽  
Internal Capsule ◽  
Cortical Reorganization ◽  
Dependent Manner ◽  
Small Compound ◽  
Function Recovery ◽  
Mediator Protein ◽  
Accelerate Rehabilitation

Brain damage such as stroke is a devastating neurological condition that may severely compromise patient quality of life. No effective medication-mediated intervention to accelerate rehabilitation has been established. We found that a small compound, edonerpic maleate, facilitated experience-driven synaptic glutamate AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic-acid) receptor delivery and resulted in the acceleration of motor function recovery after motor cortex cryoinjury in mice in a training-dependent manner through cortical reorganization. Edonerpic bound to collapsin-response-mediator-protein 2 (CRMP2) and failed to augment recovery in CRMP2-deficient mice. Edonerpic maleate enhanced motor function recovery from internal capsule hemorrhage in nonhuman primates. Thus, edonerpic maleate, a neural plasticity enhancer, could be a clinically potent small compound with which to accelerate rehabilitation after brain damage.

scholarly journals Motor Recovery and Cortical Reorganization after Constraint-Induced Movement Therapy in Stroke Patients: A Preliminary Study

2002 ◽  
Vol 16 (4) ◽  
pp. 1-13 ◽  
Author(s):  
Judith D. Schaechter ◽  
Eduard Kraft ◽  
Timothy S. Hilliard ◽  
Rick M. Dijkhuizen ◽  
Thomas Benner ◽  
...  
Keyword(s):  
Movement Therapy ◽  
Motor Recovery ◽  
Cortical Reorganization ◽  
Stroke Patients ◽  
Constraint Induced Movement Therapy ◽  
Preliminary Study

Multimodal Neuroimaging Using Concurrent EEG/fNIRS for Poststroke Recovery Assessment: An Exploratory Study

2020 ◽  
Vol 34 (12) ◽  
pp. 1099-1110
Author(s):  
Rihui Li ◽  
Sheng Li ◽  
Jinsook Roh ◽  
Chushan Wang ◽  
Yingchun Zhang
Keyword(s):  
Motor Function ◽  
Premotor Cortex ◽  
Cortical Reorganization ◽  
Healthy Controls ◽  
Multimodal Neuroimaging ◽  
Stroke Patients ◽  
Functional Near Infrared Spectroscopy ◽  
Source Imaging ◽  
Eeg Source Imaging ◽  
Function Recovery

Background Persistent motor deficits are very common in poststroke survivors and often lead to disability. Current clinical measures for profiling motor impairment and assessing poststroke recovery are largely subjective and lack precision. Objective A multimodal neuroimaging approach was developed based on concurrent functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) to identify biomarkers associated with motor function recovery and document the poststroke cortical reorganization. Methods EEG and fNIRS data were simultaneously recorded from 9 healthy controls and 18 stroke patients during a hand-clenching task. A novel fNIRS-informed EEG source imaging approach was developed to estimate cortical activity and functional connectivity. Subsequently, graph theory analysis was performed to identify network features for monitoring and predicting motor function recovery during a 4-week intervention. Results The task-evoked strength at ipsilesional primary somatosensory cortex was significantly lower in stroke patients compared with healthy controls ( P < .001). In addition, across the 4-week rehabilitation intervention, the strength at ipsilesional premotor cortex (PMC) ( R = 0.895, P = .006) and the connectivity between bilateral primary motor cortices (M1) ( R = 0.9, P = .007) increased in parallel with the improvement of motor function. Furthermore, a higher baseline strength at ipsilesional PMC was associated with a better motor function recovery ( R = 0.768, P = .007), while a higher baseline connectivity between ipsilesional supplementary motor cortex (SMA)–M1 implied a worse motor function recovery ( R = −0.745, P = .009). Conclusion The proposed multimodal EEG/fNIRS technique demonstrates a preliminary potential for monitoring and predicting poststroke motor recovery. We expect such findings can be further validated in future study.

Motor Recovery and Cortical Reorganization After Mirror Therapy in Chronic Stroke Patients

2010 ◽  
Vol 25 (3) ◽  
pp. 223-233 ◽  
Author(s):  
Marian E. Michielsen ◽  
Ruud W. Selles ◽  
Jos N. van der Geest ◽  
Martine Eckhardt ◽  
Gunes Yavuzer ◽  
...  
Keyword(s):  
Chronic Stroke ◽  
Motor Recovery ◽  
Cortical Reorganization ◽  
Mirror Therapy ◽  
Stroke Patients
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