Experience with the “Good” Limb Induces Aberrant Synaptic Plasticity in the Perilesion Cortex after Stroke

Well if using the 'good' side impairs recovery of the 'bad' side then all survivors are totally fucking screwed in trying to get 100% recovery.  Which to me means we need to stop a lot of the damage in the first place by stopping the neuronal cascade of death.
http://www.jneurosci.org/content/35/22/8604.short?
What is your doctors solution to get around this problem? I don't know is not an ok answer.

1. Soo Young Kim¹,
2. Rachel P. Allred²,*,
3. DeAnna L. Adkins⁴,*,
4. Kelly A. Tennant³,
5. Nicole A. Donlan²,
6. Jeffrey A. Kleim⁵, and
7. Theresa A. Jones²,³

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1. Author contributions: S.Y.K., R.P.A., D.L.A., J.A.K., and T.A.J. designed research; S.Y.K., R.P.A., D.L.A., K.A.T., N.A.D., and T.A.J. performed research; J.A.K. contributed unpublished reagents/analytic tools; S.Y.K., R.P.A., D.L.A., and T.A.J. analyzed data; S.Y.K. and T.A.J. wrote the paper.
2. ↵*R.P.A. and D.L.A. contributed equally to this work.

1. The Journal of Neuroscience, 3 June 2015, 35(22): 8604-8610; doi: 10.1523/JNEUROSCI.0829-15.2015

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Abstract

Following unilateral stroke, the contralateral (paretic) body side is often severely impaired, and individuals naturally learn to rely more on the nonparetic body side, which involves learning new skills with it. Such compensatory hyper-reliance on the “good” body side, however, can limit functional improvements of the paretic side. In rats, motor skill training with the nonparetic forelimb (NPT) following a unilateral infarct lessens the efficacy of rehabilitative training, and reduces neuronal activation in perilesion motor cortex. However, the underlying mechanisms remain unclear. In the present study, we investigated how forelimb movement representations and synaptic restructuring in perilesion motor cortex respond to NPT and their relationship with behavioral outcomes. Forelimb representations were diminished as a result of NPT, as revealed with intracortical microstimulation mapping. Using transmission electron microscopy and stereological analyses, we found that densities of axodendritic synapses, especially axo-spinous synapses, as well as multiple synaptic boutons were increased in the perilesion cortex by NPT. The synaptic density was negatively correlated with the functional outcome of the paretic limb, as revealed in reaching performance. Furthermore, in animals with NPT, there was dissociation between astrocytic morphological features and axo-spinous synaptic density in perilesion motor cortex, compared with controls. These findings demonstrate that skill learning with the nonparetic limb following unilateral brain damage results in aberrant synaptogenesis, potentially of transcallosal projections, and this seems to hamper the functionality of the perilesion motor cortex and the paretic forelimb.