Article

Six months after stroke onset, 50 % of patients are still disabled and dependent,
while many brain mechanisms of recovery remain partially unknown or
misunderstood. However, brain imaging and cerebral connectivity analytical
techniques have provided invaluable insights into such mechanisms and identified
two main patterns of brain reorganization depending on stroke severity. The
contralesional primary motor cortex can take over motor function in severely
impaired patients, whereas the ipsilesional motor cortex or hemisphere reorganize
themselves in good recoverers. These patterns evolve with time after stroke, and
highlight ipsilesional and contralesional primary and secondary areas that appear
to take over lost functions. The crucial role of these areas has been confirmed
by histological tracer studies. In addition, non-invasive techniques can
stimulate post-stroke brain plasticity, although appropriate targets first need
to be found. Imaging has proved useful for finding such appropriate targets and
has also provided biomarkers of efficacy with various therapies. Moreover, it has
provided some clues to the mechanisms of action of recovery-enhancing drugs.
These imaging techniques have also identified patients who show atypical
reorganization and recovery patterns. Thus, it may be necessary to design
individualized and targeted therapies.
CI - Copyright (c) 2017 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS