(Stroke. 2000;31:223.)
© 2000 American Heart Association, Inc.
Special Report |
Brain Plasticity and Stroke Rehabilitation
The Willis Lecture
Presented as the Willis Lecture at the 24th American Heart Association International Conference on Stroke and Cerebral Circulation, Nashville, Tenn, February 4, 1999. The opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.
From the Division for Experimental Neurology, Wallenberg Neuroscience Center, University Hospital, Lund, Sweden.
Correspondence to Barbro B. Johansson, MD, PhD, Division for Experimental Neurology, Wallenberg Neuroscience Center, University Hospital, S-221 85 Lund, Sweden. E-mail Barbro.Johansson{at}neurol.lu.se
Abstract—Neuronal connections and cortical maps are continuously remodeled by our experience. Knowledge of the potential capabilityof the brain to compensate for lesions is a prerequisite for optimal stroke rehabilitation strategies. Experimental focal cortical lesions induce changes in adjacent cortex and in the contralateral hemisphere. Neuroimaging studies in stroke patients indicate altered poststroke activation patterns, which suggest some functional reorganization. To what extent functional imaging data correspond to outcome data needs to be evaluated. Reorganization may be the principle process responsible for recovery of function after stroke, but what are the limits, and to what extent can postischemic intervention facilitate such changes? Postoperative housing of animals in an enriched environment can significantly enhance functional outcome and can also interact with other interventions, including neocortical grafting. What role will neuronal progenitor cells play in future rehabilitation—stimulated in situ or as neural replacement? And what is the future for blocking neural growth inhibitory factors? Better knowledge of postischemic molecular and neurophysiological events, and close interaction between basic and applied research, will hopefully enable us to design rehabilitation strategies based on neurobiological principles in a not-too-distant future.
Key Words: neuronal plasticity • recovery • rehabilitation • stroke
This article has been cited by other articles:
 |
|
 |
|
  L.-R. Zhao, S. Singhal, W.-M. Duan, J. Mehta, and J. A. Kessler Brain Repair by Hematopoietic Growth Factors in a Rat Model of Stroke Stroke, September 1, 2007; 38(9): 2584 - 2591. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. G. Lindberg, C. Schmitz, M. Engardt, H. Forssberg, and J. Borg Use-Dependent Up- and Down-Regulation of Sensorimotor Brain Circuits in Stroke Patients Neurorehabil Neural Repair, July 1, 2007; 21(4): 315 - 326. [Abstract] [PDF]
|
|
|
|
 |
|
 L. A Boyd, E. D Vidoni, and J. J Daly Answering the Call: The Influence of Neuroimaging and Electrophysiological Evidence on Rehabilitation Physical Therapy, June 1, 2007; 87(6): 684 - 703. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. F. Johnston, C. Yang, K.-K. Hui, B. Xiao, X. Li, and A. Rusiewicz Acupuncture for Chemotherapy-Associated Cognitive Dysfunction: A Hypothesis-Generating Literature Review to Inform Clinical Advice Integr Cancer Ther, March 1, 2007; 6(1): 36 - 41. [Abstract] [PDF]
|
|
|
|
|
|
J.-C. Chen, C.-C. Liang, and F.-Z. Shaw Facilitation of Sensory and Motor Recovery by Thermal Intervention for the Hemiplegic Upper Limb in Acute Stroke Patients: A Single-Blind Randomized Clinical Trial Stroke, December 1, 2005; 36(12): 2665 - 2669. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Jaillard, C. D. Martin, K. Garambois, J. F. Lebas, and M. Hommel Vicarious function within the human primary motor cortex?: A longitudinal fMRI stroke study Brain, May 1, 2005; 128(5): 1122 - 1138. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. N. Alexander, S. Cen, K. J. Sullivan, G. Bhavnani, X. Ma, S. P. Azen, and ASAP Study Group Effects of Acupuncture Treatment on Poststroke Motor Recovery and Physical Function: A Pilot Study Neurorehabil Neural Repair, December 1, 2004; 18(4): 259 - 267. [Abstract] [PDF]
|
|
|
|
 |
|
 F Alarcon, J C M Zijlmans, G Duenas, and N Cevallos Post-stroke movement disorders: report of 56 patients J. Neurol. Neurosurg. Psychiatry, November 1, 2004; 75(11): 1568 - 1574. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. R. Dinse Sound Case for Enrichment. Focus on "Environmental Enrichment Improves Response Strength, Threshold, Selectivity, and Latency of Auditory Cortex Neurons" J Neurophysiol, July 1, 2004; 92(1): 36 - 37. [Full Text] [PDF]
|
|
|
|
|
|
J. Bernhardt, H. Dewey, A. Thrift, and G. Donnan Inactive and Alone: Physical Activity Within the First 14 Days of Acute Stroke Unit Care Stroke, April 1, 2004; 35(4): 1005 - 1009. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. H Crosbie, S. M McDonough, D. H Gilmore, and M I. Wiggam The adjunctive role of mental practice in the rehabilitation of the upper limb after hemiplegic stroke: a pilot studya Clinical Rehabilitation, January 1, 2004; 18(1): 60 - 68. [Abstract] [PDF]
|
|
|
|
|
|
N. Byl, J. Roderick, O. Mohamed, M. Hanny, J. Kotler, A. Smith, M. Tang, and G. Abrams Effectiveness of Sensory and Motor Rehabilitation of the Upper Limb Following the Principles of Neuroplasticity: Patients Stable Poststroke Neurorehabil Neural Repair, September 1, 2003; 17(3): 176 - 191. [Abstract] [PDF]
|
|
|
|
|
|
T Ago, T Kitazono, H Ooboshi, J Takada, T Yoshiura, F Mihara, S Ibayashi, and M Iida Deterioration of pre-existing hemiparesis brought about by subsequent ipsilateral lacunar infarction J. Neurol. Neurosurg. Psychiatry, August 1, 2003; 74(8): 1152 - 1153. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Dijkhuizen, A. B. Singhal, J. B. Mandeville, O. Wu, E. F. Halpern, S. P. Finklestein, B. R. Rosen, and E. H. Lo Correlation between Brain Reorganization, Ischemic Damage, and Neurologic Status after Transient Focal Cerebral Ischemia in Rats: A Functional Magnetic Resonance Imaging Study J. Neurosci., January 15, 2003; 23(2): 510 - 517. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Gladstone, S. E. Black, and A. M. Hakim Toward Wisdom From Failure: Lessons From Neuroprotective Stroke Trials and New Therapeutic Directions Stroke, August 1, 2002; 33(8): 2123 - 2136. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. L. Small, P. Hlustik, D. C. Noll, C. Genovese, and A. Solodkin Cerebellar hemispheric activation ipsilateral to the paretic hand correlates with functional recovery after stroke Brain, July 1, 2002; 125(7): 1544 - 1557. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. H. Cauraugh and S. Kim Two Coupled Motor Recovery Protocols Are Better Than One: Electromyogram-Triggered Neuromuscular Stimulation and Bilateral Movements Stroke, June 1, 2002; 33(6): 1589 - 1594. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Hachinski Stroke: The Next 30 Years Stroke, January 1, 2002; 33(1): 1 - 4. [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Dijkhuizen, J. Ren, J. B. Mandeville, O. Wu, F. M. Ozdag, M. A. Moskowitz, B. R. Rosen, and S. P. Finklestein Functional magnetic resonance imaging of reorganization in rat brain after stroke PNAS, October 12, 2001; (2001) 231235598. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Nilsson, J. Carlsson, A. Danielsson, A. Fugl-Meyer, K. Hellstrom, L. Kristensen, B. Sjolund, K. S. Sunnerhagen, and G. Grimby Walking training of patients with hemiparesis at an early stage after stroke: a comparison of walking training on a treadmill with body weight support and walking training on the ground Clinical Rehabilitation, May 1, 2001; 15(5): 515 - 527. [Abstract] [PDF]
|
|
|
|
|
|
B. B. Johansson, E. Haker, M. von Arbin, M. Britton, G. Langstrom, A. Terent, D. Ursing, and K. Asplund Acupuncture and Transcutaneous Nerve Stimulation in Stroke Rehabilitation : A Randomized, Controlled Trial Stroke, March 1, 2001; 32(3): 707 - 713. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. J. Seil and R. Drake-Baumann TrkB Receptor Ligands Promote Activity-Dependent Inhibitory Synaptogenesis J. Neurosci., July 15, 2000; 20(14): 5367 - 5373. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. M. Dijkhuizen, J. Ren, J. B. Mandeville, O. Wu, F. M. Ozdag, M. A. Moskowitz, B. R. Rosen, and S. P. Finklestein Functional magnetic resonance imaging of reorganization in rat brain after stroke PNAS, October 23, 2001; 98(22): 12766 - 12771. [Abstract] [Full Text] [PDF]
|
|