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Motor compensation and its effects on neural reorganization after stroke

2017; Nature Portfolio; Volume: 18; Issue: 5 Linguagem: Inglês

10.1038/nrn.2017.26

1471-0048

Theresa A. Jones,

Botulinum Toxin and Related Neurological Disorders

Stroke survivors often adapt to the loss of upper-limb function by adopting compensatory strategies. Jones discusses evidence that these compensatory strategies may influence the neural remodelling processes that occur after the initial stroke and can have mixed effects on functional outcome of the paretic limb. Stroke instigates a dynamic process of repair and remodelling of remaining neural circuits, and this process is shaped by behavioural experiences. The onset of motor disability simultaneously creates a powerful incentive to develop new, compensatory ways of performing daily activities. Compensatory movement strategies that are developed in response to motor impairments can be a dominant force in shaping post-stroke neural remodelling responses and can have mixed effects on functional outcome. The possibility of selectively harnessing the effects of compensatory behaviour on neural reorganization is still an insufficiently explored route for optimizing functional outcome after stroke.