Clinical and neurobiological aspects of stroke recovery
Recovery of Function
Seminal observations in patients following a stroke affecting the motor cortex or related corticospinal pathway led to the notion that central neural activation in motor pathways is engaged in a spatially and temporally stereotyped manner for those who recover motor deficits. The notion of a "motor recovery program" is reinforced by animal experiments in which adaptive plasticity of cortical activity underlying new motor behavior is monitored using direct electrophysiological techniques, as well as studies involving novel clinical neuroimaging and unique applications of bioengineering applied to humans. The emerging conclusions from these preclinical and clinical studies are that motor recovery after stroke involves pathways identical to those engaged in motor learning. Motor recovery should be viewed as a learning opportunity modifiable by the same behavior, stimulation, or drugs that enhance motor learning. It follows then that the history of dim or severely limited expectations for motor recovery following stroke might give way to more aggressive novel approaches based on years of data accumulated on motor learning. © 2007 Elsevier Inc. All rights reserved.
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