Post-stroke plastic reorganisation in the adult brain

Rossini, Paolo Maria; Calautti, Cinzia; Pauri, Flavia; Baron, Jean‐Claude

doi:10.1016/s1474-4422(03)00485-x

Cited by 400 publications

(298 citation statements)

References 121 publications

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“…Nevertheless, movements of the non-dominant hand have consistently been reported to induce a much more bilateral activation pattern (Kobayashi et al, 2003;Verstynen et al, 2005). Similarly, participation of these regions for left-hand movements to the recovery of motor skills has amply been documented in stroke patients Rossini et al, 2003;Ward, 2005) or patients with a tumor or undergoing surgery (Duffau, 2000;Duffau and Capelle, 2001a,b;Krainik et al, 2004), or with multiple sclerosis (Rocca et al, 2005). More recently, studies of functional connectivity, particularly on healthy subjects in resting state (Biswal et al, 1995;Lowe et al, 1998;Xiong et al, 1999) have confirmed that these regions of the motor network are strongly correlated to one another.…”

Section: Discussionmentioning

confidence: 99%

Partial correlation for functional brain interactivity investigation in functional MRI

et al. 2006

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Section: Discussionmentioning

confidence: 99%

Partial correlation for functional brain interactivity investigation in functional MRI

et al. 2006

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“…[1][2][3][4][5][6] One limitation of training protocols is that patients with more profound weakness are unable to carry out the motor routines required. The finding that passively elicited motions lead to activation and cortical reorganization in brain regions common to those activated with performance of voluntary movements suggested that it could also elicit improvements in motor function.…”

Section: Role Of Volition In Motor Learningmentioning

confidence: 99%

Volition and Imagery in Neurorehabilitation

Lotze

Cohen

2006

Cognitive and Behavioral Neurology

106

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New interventional approaches have been proposed in the last few years to treat the motor deficits resulting from brain lesions. Training protocols represent the gold-standard of these approaches. However, the degree of motor recovery experienced by most patients remains incomplete. It would be important to improve our understanding of the mechanisms underlying functional recovery. This chapter examines the role of two possible mechanisms that could operate to improve motor function in this setting: volition and motor imagery. It is argued that both represent possible strategies to enhance training effects.Key Words: motivation, attention, motor imagery, hemiparesis, rehabilitation, forced use, volition, stroke, motor system, motor cortex (Cog Behav Neurol 2006;19:135-140) M otor training protocols represent one of the fundamental bases of rehabilitative treatments after brain damage. Different strategies have been proposed to enhance training effects, including enhanced motivation, focused attention, motor imagery, progressive transfer of tasks towards the paretic limb, forced use, and integration of multimodal and emotional settings. The neural mechanisms underlying these strategies are poorly understood. In this review, we describe studies performed to better understand the influence of some of these factors on performance improvements and changes in intracortical excitatory and inhibitory mechanisms in humans undergoing training protocols. Focus is on the role of (a) volition in motor learning, (b) imagery in neurorehabilitation and motor control, and (c) neural substrates underlying performance of simple and complex movements after stroke. ROLE OF VOLITION IN MOTOR LEARNINGMotor training protocols in patients with brain lesions elicit well-described changes in brain organization and performance improvements. [1][2][3][4][5][6] One limitation of training protocols is that patients with more profound weakness are unable to carry out the motor routines required. The finding that passively elicited motions lead to activation and cortical reorganization in brain regions common to those activated with performance of voluntary movements suggested that it could also elicit improvements in motor function. 7,8 This proposal has important implications for the design of neurorehabilitative treatments after stroke, particularly in patients who are too weak to perform effective voluntary motor training.One recent study compared behavioral gains after short-term motor learning, changes in functional magnetic resonance imaging (fMRI) activation in the contralateral primary motor cortex (cM1) and in motor cortex excitability measured with transcranial magnetic stimulation (TMS) after a 30 minute training period consisting of either voluntarily or passively induced wrist movements in 2 different sessions in healthy volunteers. 9 During active training, subjects were instructed to perform voluntary wrist flexion-extension movements of a specified duration in an articulated splint. Therefore, voluntary movements f...

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“…After stroke, for instance, scans for functions that used to be performed by the damaged region often show that this function has moved to the perilesional area or has become widespread. 5 The partial return of function that occurs after stroke or head injury is largely due to this plasticity. The ability of young children to recover motor skills better than adults after damage to their nervous system is considered to be due to the greater plasticity of the infant CNS.…”

Section: Plasticitymentioning

confidence: 99%

Novel strategies for protection and repair of the central nervous system

Fawcett

2006

Clinical Medicine

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-Clinical possibilities in many neurological conditions are limited by our current inability to correct structural damage to the nervous system, and treatments to prevent damage are also limited. Current research has produced promising treatments that promote neuroprotection, plasticity, axon regeneration, remyelination and cell replacement. As these treatments go through clinical trials and enter the clinic, the treatment of several neurological conditions will change greatly.

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Post-stroke plastic reorganisation in the adult brain

Cited by 400 publications

References 121 publications

Partial correlation for functional brain interactivity investigation in functional MRI

Partial correlation for functional brain interactivity investigation in functional MRI

Volition and Imagery in Neurorehabilitation

Novel strategies for protection and repair of the central nervous system

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