Mechanisms of functional recovery after stroke.

Stroke is a leading cause of disability. After initial stabilization, neurologic recovery takes place even in the acute phase. Well-known recovery mechanisms from stroke deficits are improvement from diaschisis, or functional reorganization of the ipsilesional or contralesional cortex with involvement of uncrossed corticospinal tract fibers. The importance of coactivation of the perilesional or contralesional cortex is unknown; however, neuronal plasticity plays an important role in neurologic recovery. With the recent advancements in knowledge regarding underlying mechanisms of neuronal plasticity, various functional modulating methods have been developed and studied in humans. In this review, basic mechanisms of functional recovery and potential targets for future research will be discussed.

[1]  Elad I Levy,et al.  Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial , 2012, The Lancet.

[2]  J. Lefaucheur,et al.  Stroke rehabilitation using noninvasive cortical stimulation: motor deficit , 2012, Expert review of neurotherapeutics.

[3]  A. Ergul,et al.  Angiogenesis: A Harmonized Target for Recovery After Stroke , 2012, Stroke.

[4]  N. Takeuchi,et al.  Maladaptive Plasticity for Motor Recovery after Stroke: Mechanisms and Approaches , 2012, Neural plasticity.

[5]  Milos Pekny,et al.  Modulation of Neural Plasticity as a Basis for Stroke Rehabilitation , 2012, Stroke.

[6]  J. Montaner,et al.  A large screening of angiogenesis biomarkers and their association with neurological outcome after ischemic stroke. , 2011, Atherosclerosis.

[7]  F. Chollet,et al.  Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): a randomised placebo-controlled trial , 2011, The Lancet Neurology.

[8]  G. Wittenberg,et al.  The neural basis of constraint-induced movement therapy , 2009, Current opinion in neurology.

[9]  Joanna Wardlaw,et al.  Stroke treatment with alteplase given 3·0–4·5 h after onset of acute ischaemic stroke (ECASS III): additional outcomes and subgroup analysis of a randomised controlled trial , 2009, The Lancet Neurology.

[10]  M. Chopp,et al.  Neurorestorative therapies for stroke: underlying mechanisms and translation to the clinic , 2009, The Lancet Neurology.

[11]  S. Mayer,et al.  Efficacy and safety of recombinant activated factor VII for acute intracerebral hemorrhage. , 2008, The New England journal of medicine.

[12]  C. Anderson,et al.  Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial , 2008, The Lancet Neurology.

[13]  Gert Kwakkel,et al.  Impact of Time on Improvement of Outcome After Stroke , 2006, Stroke.

[14]  Lin Xie,et al.  Evidence for stroke-induced neurogenesis in the human brain , 2006, Proceedings of the National Academy of Sciences.

[15]  J. Krakauer.  Motor learning: its relevance to stroke recovery and neurorehabilitation. , 2006, Current opinion in neurology.

[16]  J. Krakauer.  Arm function after stroke: from physiology to recovery. , 2005, Seminars in neurology.

[17]  Ichiro Watanabe,et al.  Repetitive Transcranial Magnetic Stimulation of Contralesional Primary Motor Cortex Improves Hand Function After Stroke , 2005, Stroke.

[18]  Ann M. Stowe,et al.  Extensive Cortical Rewiring after Brain Injury , 2005, The Journal of Neuroscience.

[19]  Yoshihiro Takayama,et al.  The mechanisms of recovery from cerebellar infarction: an fMRI study , 2003, Neuroreport.

[20]  Sang Ho Ahn,et al.  Bilateral primary sensori‐motor cortex activation of post‐stroke mirror movements: an fMRI study , 2003, Neuroreport.

[21]  Simon J Graham,et al.  Somatosensory Gating and Recovery From Stroke Involving the Thalamus , 2002, Stroke.

[22]  F. Müller,et al.  Effect of levodopa in combination with physiotherapy on functional motor recovery after stroke: a prospective, randomised, double-blind study , 2001, The Lancet.

[23]  G. Abbruzzese,et al.  Motor recovery following stroke: a transcranial magnetic stimulation study , 2000, Clinical Neurophysiology.

[24]  C. Price,et al.  Mechanisms of recovery from aphasia: evidence from positron emission tomography studies , 1999, Journal of neurology, neurosurgery, and psychiatry.

[25]  R. Nudo,et al.  Reorganization of movement representations in primary motor cortex following focal ischemic infarcts in adult squirrel monkeys. , 1996, Journal of neurophysiology.

[26]  G Marchal,et al.  Contralateral cerebellar hypometabolism: a predictor for stroke outcome? , 1994, Journal of neurology, neurosurgery, and psychiatry.

[27]  F Fazio,et al.  Aphasia and neglect after subcortical stroke. A clinical/cerebral perfusion correlation study. , 1987, Brain : a journal of neurology.

[28]  D. Knopman,et al.  Mechanisms of recovery from aphasia: Evidence from serial xenon 133 cerebral blood flow studies , 1984, Annals of neurology.

[29]  P M Rossini,et al.  Mapping of motor cortical reorganization after stroke. A brain stimulation study with focal magnetic pulses. , 1997, Stroke.