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Mechanisms Underlying Functional Recovery Following Stroke

Published online by Cambridge University Press:  18 September 2015

Robert G. Lee*
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary
Paul van Donkelaar
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary
*
Faculty of Medicine, Department of Clinical Neurosciences, University of Calgary, 3330 Hospital Drive N.W., Calgary, Alberta, Canada T2N4N1
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Abstract

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This article reviews recent evidence from animal experiments indicating that there is considerable potential for reorganization of representations and functions in sensory and motor cortex following localized lesions or various manipulations of peripheral target structures. Three major mechanisms for this plastic reorganization are considered: unmasking of existing but functionally inactive pathways, sprouting of fibers from surviving neurons and formation of new synapses, and redundancy of CNS circuitry allowing alternative pathways to take over functions. Studies using positron emission tomography or transcranial magnetic stimulation suggest that similar forms of neuroplasticity may occur in the human brain and could contribute to functional recovery following stroke. The potential therapeutic implications are discussed.

Résumé

Résumé

Nous revoyons les données récentes de l’expérimentation animale indiquant qu’il existe un potentiel considérable de réorganisation des représentations et des fonctions dans le cortex sensitif et moteur suite à des lésions localisées ou à des manipulations variées de structures cibles périphériques. Nous considérons trois mécanismes majeurs de cette réorganisation plastique: la manifestation de voies existantes mais fonctionnellement inactives, le bourgeonnement de fibres à partir de neurones survivants et la formation de nouvelles synapses, et la redondance de circuits du SNC permettant à des voies alternatives de prendre la relève. Des études faites à l’aide de la tomographie par émission de positrons ou de stimulation magnétique transcrânienne suggèrent que des formes analogues de neuroplasticité pourraient exister dans le cerveau humain et pourraient contribuer à la récupération fonctionnelle suite à un accident vasculaire cérébral. Nous discutons des implications thérapeutiques potentielles.

Type
Review Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

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