Journal article
Evidence for a window of enhanced plasticity in the human motor cortex following ischemic stroke
Neurorehabilitation and Neural Repair, Vol.35(4), pp.307-320
2021
Abstract
Background
In preclinical models, behavioral training early after stroke produces larger gains compared with delayed training. The effects are thought to be mediated by increased and widespread reorganization of synaptic connections in the brain. It is viewed as a period of spontaneous biological recovery during which synaptic plasticity is increased.
Objective
To look for evidence of a similar change in synaptic plasticity in the human brain in the weeks and months after ischemic stroke.
Methods
We used continuous theta burst stimulation (cTBS) to activate synapses repeatedly in the motor cortex. This initiates early stages of synaptic plasticity that temporarily reduces cortical excitability and motor-evoked potential amplitude. Thus, the greater the effect of cTBS on the motor-evoked potential, the greater the inferred level of synaptic plasticity. Data were collected from separate cohorts (Australia and UK). In each cohort, serial measurements were made in the weeks to months following stroke. Data were obtained for the ipsilesional motor cortex in 31 stroke survivors (Australia, 66.6 ± 17.8 years) over 12 months and the contralesional motor cortex in 29 stroke survivors (UK, 68.2 ± 9.8 years) over 6 months.
Results
Depression of cortical excitability by cTBS was most prominent shortly after stroke in the contralesional hemisphere and diminished over subsequent sessions (P = .030). cTBS response did not differ across the 12-month follow-up period in the ipsilesional hemisphere (P = .903).
Conclusions
Our results provide the first neurophysiological evidence consistent with a period of enhanced synaptic plasticity in the human brain after stroke. Behavioral training given during this period may be especially effective in supporting poststroke recovery.
Details
- Title
- Evidence for a window of enhanced plasticity in the human motor cortex following ischemic stroke
- Authors/Creators
- B. Hordacre (Author/Creator) - University of South AustraliaD. Austin (Author/Creator) - UCL Institute of NeurologyK.E. Brown (Author/Creator) - UCL Institute of NeurologyL. Graetz (Author/Creator) - The University of AdelaideI. Pareés (Author/Creator) - Hospital Universitario Ramón y CajalS. De Trane (Author/Creator) - National Hospital for Neurology and NeurosurgeryA-M Vallence (Author/Creator) - Murdoch UniversityS. Koblar (Author/Creator) - Royal Adelaide HospitalT. Kleinig (Author/Creator) - Royal Adelaide HospitalM.N. McDonnell (Author/Creator) - The Physio Clinic, Adelaide, South Australia, Australia.R. Greenwood (Author/Creator) - National Hospital for Neurology and NeurosurgeryM.C. Ridding (Author/Creator) - University of South AustraliaJ.C. Rothwell (Author/Creator) - UCL Institute of Neurology
- Publication Details
- Neurorehabilitation and Neural Repair, Vol.35(4), pp.307-320
- Publisher
- Sage
- Identifiers
- 991005544954707891
- Copyright
- © 2021 by American Society of Neurorehabilitation
- Murdoch Affiliation
- Centre for Molecular Medicine and Innovative Therapeutics
- Language
- English
- Resource Type
- Journal article
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- Domestic collaboration
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- Citation topics
- 1 Clinical & Life Sciences
- 1.82 Gait & Posture
- 1.82.811 Transcranial Magnetic Stimulation
- Web Of Science research areas
- Clinical Neurology
- Rehabilitation
- ESI research areas
- Neuroscience & Behavior