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Review : The Neurobiology of Stroke Rehabilitation

Department of Neurology, University of Maryland School of Medicine Baltimore, Maryland, Kernan Rehabilitation Hospital, University of Maryland School of Medicine Baltimore, Maryland

Ana Solodkin

Kernan Rehabilitation Hospital, University of Maryland School of Medicine Baltimore, Maryland, Department of Anatomy and Neurobiology (AS) University of Maryland School of Medicine Baltimore, Maryland

Cerebrovascular disease plays a paramount role in mortality and morbidity, and the clinical and basic sci entific study of acute stroke has blossomed, leading both to increased survival and to increasing numbers of people with disabilities from stroke. Neurobiological study of the chronic form of this prevalent neurological disease has lagged behind investigation of the acute illness. This article reviews how and why this situation will change. Four major points are addressed: 1) The anatomical organizations of functional brain systems are less topographically precise than commonly believed. 2) Cortical plasticity exists in adults and takes a number of forms, including unmasking of existing circuits, growth of new synapses via axonal sprouting or dendritic proliferation, and development of compensatory processes. 3) It is possible to manipulate this plasticity with behavioral and pharmacological interventions, and such manipulations can have a beneficial effect on recovery. 4) Functional neuroimaging, particularly the noninvasive method of fMRI, can be used to study in vivo both cerebral plasticity after stroke and the interventions that might influence recovery by affecting this plasticity. Although there is much to be accomplished, the prognosis is extremely good for a neuroscience of stroke rehabilitation. NEUROSCIENTIST 4:426-434, 1998

Key Words: KEY WORDS Stroke • Rehabilitation • Plasticity • Motor • Language • Therapy

The Neuroscientist, Vol. 4, No. 6, 426-434 (1998)
DOI: 10.1177/107385849800400614


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