Functional Brain Reorganization in Stroke Recovery

中风后基本感觉、运动、高级认知和语言功能的恢复过程尚不清楚。此外，人们对调节治疗效果的神经生理机制也知之甚少，比如以增强恢复过程而闻名的约束诱导疗法（CIT）。然而，有人认为，从根本上说，恢复是大脑功能重组的结果。在功能性神经影像学出现之前，支持这一观点的证据完全由临床或行为数据的间接推断组成。然而，最近，我们和其他人已经开始使用脑磁图（MEG）和其他功能神经成像方法

The process of recovery of basic sensory, motor, and higher cognitive and linguistic functions, following stroke, is not well understood. Also poorly understood are the neurophysiological mechanisms that mediate the effectiveness of therapies, like the Constraint-Induced Therapy (CIT), which are reputed to enhance the recovery process. It has been suggested, however, that, fundamentally, recovery is a result of functional reorganization of the brain. Before the advent of functional neuroimaging, evidence supporting this notion consisted entirely of indirect inferences from clinical or behavioral data. Recently, however, we and others, using Magnetoencephalography (MEG) and other functional neuroimaging methods, have begun accumulating direct evidence of brain plasticity and functional reorganization. In this Program Project we plan to investigate systematically the extent and type of reorganization, using MEG-derived brain activation profiles, during spontaneous recovery from stroke, of the following behavioral and cognitive functions: First, expressive and receptive language; second, motor; and third, somatosensory and spatial attention functions. We also plan to study the effects of CIT used to enhance the recovery process of language and sensorimotor functions, on these activation profiles. We expect that the extent and type of reorganization observed will vary as a function of lesion parameters, assessed through structural MRI, and neuropsychological testing. Finally, we will attempt to specify the repercussions of reorganization of the mechanisms of the compromised functions for the mechanisms of functions unaffected by the stroke using, once again, MEG mapping.