Deans' stroke musings: Ipsilateral motor pathways after stroke: Implications for noninvasive brain stimulation

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, September 8, 2019

Ipsilateral motor pathways after stroke: Implications for noninvasive brain stimulation

Useless, drawing attention to whatever does nothing to get survivors recovered

Ipsilateral motor pathways after stroke: Implications for noninvasive brain stimulation

Janine Reis, Albert-Ludwigs-University Freiburg, Germany Reviewed by: Robert Chen,TorontoWestern Hospital, Canada Yoshikazu Ugawa, Fukushima Medical University, Japan *Correspondence: Winston D. Byblow, Department of Sport and Exercise Science,The University of Auckland, Private Bag 92012, Auckland 1142, New Zealand. e-mail: w.byblow@auckland.ac.nz †LynleyV. Bradnam andWinston D. Byblow have contributed equally to this work.

In humans the two cerebral hemispheres have essential roles in controlling the upper limb.The purpose of this article is to draw attention to the potential importance of ipsilateral descending pathways for functional recovery after stroke, and the use of non-invasive brainstimulation(NBS) protocols of the contralesional primary motor cortex(M1).Conventionally NBS is used to suppress contralesional M1,and to attenuate transcallosal inhibition onto the ipsilesional M1.There has been little consideration of the fact that contralesional M1 suppression may also reduce excitability of ipsilateral descending pathways that may be important for paretic upper limb control for some patients.One such ipsilateral pathway is the cortico-reticulo-propriospinal pathway (CRPP). In this review we outline a neurophysiological model to explain how contralesional M1 may gain control of the paretic arm via the CRPP. We conclude that the relative importance of the CRPP for motor control in individual patients must be considered before using NBS to suppress contralesional M1. Neurophysiological, neuroimaging, and clinical assessments can assist this decision making and facilitate the translation of NBS into the clinical setting.