Article

Despite the plethora of human neurophysiological research, the bilateral
involvement of the leg motor cortical areas and their interhemispheric
interaction during both normal and impaired human walking is poorly understood.
Using transcranial magnetic stimulation (TMS), we have expanded our understanding
of the role upper-extremity motor cortical areas play in normal movements and how
stroke alters this role, and probed the efficacy of interventions to improve
post-stroke arm function. However, similar investigations of the legs have lagged
behind, in part, due to the anatomical difficulty in using TMS to stimulate the
leg motor cortical areas. Additionally, leg movements are predominately
bilaterally controlled and require interlimb coordination that may involve both
hemispheres. The sensitive, but invasive, tools used in animal models of
locomotion hold great potential for increasing our understanding of the
bihemispheric motor cortical control of walking. In this review, we discuss 3
themes associated with the bihemispheric motor cortical control of walking after
stroke: (a) what is known about the role of the bihemispheric motor cortical
control in healthy and poststroke leg movements, (b) how the neural remodeling of
the contralesional hemisphere can affect walking recovery after a stroke, and (c)
what is the effect of behavioral rehabilitation training of walking on the neural
remodeling of the motor cortical areas bilaterally.
For each theme, we discuss
how rodent models can enhance the present knowledge on human walking by testing
hypotheses that cannot be investigated in humans, and how these findings can then
be back-translated into the neurorehabilitation of poststroke walking.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS