Functional Weight of Somatic and Cognitive Networks and Asymmetry of Compensatory Mechanisms: Collaboration or Divergency among Hemispheres after Cerebrovascular Accident?

Abstract

The human brain holds highly sophisticated compensatory mechanisms relying on neuroplasticity. Neuronal degeneracy, redundancy, and brain network organization make the human nervous system more robust and evolvable to continuously guarantee an optimal environmental-related homeostasis. Nevertheless, after injury, restitution processes appear dissimilar, depending on the pathology. Following a cerebrovascular accident, asymmetry, within- and across-network compensation and interhemispheric inhibition are key features to functional recovery. In moderate-to-severe stroke, neurological outcome is often poor, and little is known about the paths that enable either an efficient collaboration among hemispheres or, on the contrary, an antagonism of adaptative responses. In this review, we aim to decipher key issues of ipsilesional and contralesional hemispheric functioning allowing the foundations of effective neurorehabilitation strategies.

Brain Asymmetry: Towards an Asymmetrical Neurovisceral Integration

“…This compensatory response is therefore an attempt to maintain homeostasis. This may partly explain the dynamic nature of brain asymmetry, which can be extended to the general concept of neurovisceral integration [80] (Figure 2).…”

After 55 Years of Neurorehabilitation, What Is the Plan?

“…Additionally, a careful definition of adjustment variables and their timing should be incorporated. All these conditions, although necessary, are probably not sufficient for an optimal outcome in the standardized context provided by RCTs [ 73 ].…”