Publication

Role of the contralesional hemisphere in post-stroke recovery of upper extremity motor function

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Last modified
  • 05/20/2025
Type of Material
Authors
    Cathrin Buetefisch, Emory University
Language
  • English
Date
  • 2015-10-16
Publisher
  • Frontiers Media
Publication Version
Copyright Statement
  • © 2015 Buetefisch.
License
Final Published Version (URL)
Title of Journal or Parent Work
ISSN
  • 1664-2295
Volume
  • 6
Issue
  • OCT
Start Page
  • 214
End Page
  • 214
Grant/Funding Information
  • CB was supported by NINDS (R56NS070879, R01NS060830, and 1R01NS090677-01A1) and NICHD (R21HD067906 and 1R01NS090677-01A1).
Abstract
  • Identification of optimal treatment strategies to improve recovery is limited by the incomplete understanding of the neurobiological principles of recovery. Motor cortex (M1) reorganization of the lesioned hemisphere (ipsilesional M1) plays a major role in post-stroke motor recovery and is a primary target for rehabilitation therapy. Reorganization of M1 in the hemisphere contralateral to the stroke (contralesional M1) may, however, serve as an additional source of cortical reorganization and related recovery. The extent and outcome of such reorganization depends on many factors, including lesion size and time since stroke. In the chronic phase post-stroke, contralesional M1 seems to interfere with motor function of the paretic limb in a subset of patients, possibly through abnormally increased inhibition of lesioned M1 by the contralesional M1. In such patients, decreasing contralesional M1 excitability by cortical stimulation results in improved performance of the paretic limb. However, emerging evidence suggests a potentially supportive role of contralesional M1. After infarction of M1 or its corticospinal projections, there is abnormally increased excitatory neural activity and activation in contralesional M1 that correlates with favorable motor recovery. Decreasing contralesional M1 excitability in these patients may result in deterioration of paretic limb performance. In animal stroke models, reorganizational changes in contralesional M1 depend on the lesion size and rehabilitation treatment and include long-term changes in neurotransmitter systems, dendritic growth, and synapse formation. While there is, therefore, some evidence that activity in contralesional M1 will impact the extent of motor function of the paretic limb in the subacute and chronic phase post-stroke and may serve as a new target for rehabilitation treatment strategies, the precise factors that specifically influence its role in the recovery process remain to be defined.
Author Notes
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Research Categories
  • Biology, Neuroscience
  • Health Sciences, Radiology

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