Pathophysiology of stroke rehabilitation: the natural course of clinical recovery, use-dependent plasticity and rehabilitative outcome

Even though the disruption of motor activity and function caused by stroke is at times severe, recovery is often highly dynamic. Recuperation reflects the ability of the neuronal network to adapt. Next to an unmasking of latent network representations, other adaptive processes, such as excitatory me...

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Bibliographic Details
Main Authors: Kreisel, Stefan H. (Author) , Hennerici, Michael G. (Author) , Bäzner, Hansjörg (Author)
Format: Article (Journal)
Language:English
Published: 2007
In: Cerebrovascular diseases
Year: 2007, Volume: 23, Issue: 4, Pages: 243-255
ISSN:1421-9786
DOI:10.1159/000098323
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1159/000098323
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Author Notes:Stefan H. Kreisel, Michael G. Hennerici, Hansjörg Bäzner
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Summary:Even though the disruption of motor activity and function caused by stroke is at times severe, recovery is often highly dynamic. Recuperation reflects the ability of the neuronal network to adapt. Next to an unmasking of latent network representations, other adaptive processes, such as excitatory metabolic stress, an imbalance in activating and inhibiting transmission, leading to salient hyperexcitability, or the consolidation of novel connections, prime the plastic capabilities of the system. Rehabilitative interventions may modulate mechanisms of neurofunctional plasticity and influence the natural course after stroke, both positively, but potentially also acting detrimentally. Though routine rehabilitative procedures are an integral part of stroke care, evidence as to their effectiveness remains equivocal. The present review describes the natural course of motor recovery, focusing on ischemic stroke, and discusses use- and training-dependent adaptive effects. It complements a prior article which highlighted the pathophysiology of plasticity. Though the interaction between rehabilitation and plasticity remains elusive, an attempt is made to clarify how and to what extent rehabilitative therapy shapes motor recovery.
Item Description:Published online: December 29, 2006
Gesehen am 04.05.2022
Physical Description:Online Resource
ISSN:1421-9786
DOI:10.1159/000098323