http://nro.sagepub.com/content/20/4/359?etoc
- 1Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- 2Brain Research Institute, University of Zurich, Zurich, Switzerland
- 3Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Michelle L. Starkey, University of Zurich, Balgrist University Hospital, Forchstrasse 340, CH-8008 Zurich, Switzerland Email: mstarkey@paralab.balgrist.ch
Abstract
Stroke is a common problem, and with an
aging population, it is likely to become more so. Outcomes from stroke
are wide ranging
from death to complete recovery, but the majority
result in severe motor impairments that affect quality of life and
become
a burden on health care systems, family, and
friends. Therapeutically, removal of thromboses can greatly improve
outcomes,
but for many stroke sufferers, the only currently
available therapy is rehabilitative training in which spared brain areas
and fiber tracts are strengthened and trained to
take over new functions. Experimental data in animals show that this is
in
part based on changes in the connectivity of the
brain and spinal cord and on the growth of new nerve fiber branches, a
process
called structural plasticity. So, just how plastic
is the brain after a stroke? In this review, we explore the factors that
affect plasticity after strokes, such as age and
the overall size and location of the lesion. We discuss the peri-infarct
area as extensive research has shown that processes
occurring there are likely to be involved mechanistically in plastic
changes
in cortical circuitry. Finally, we review promising
interventions being tested preclinically and discuss those that have
been
translated into clinical research. (Note the weasel words here, promising not specifying how efficacious these are)
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