Mechanisms of cortical plasticity and facilitation of functional recovery following stroke

人类大脑的特定区域已经被证明在大脑或外周神经受损后会重组。这种重组在年轻和老年受试者中都可以看到，并且被认为有助于恢复功能。例如，中风后，病人最初可能不能移动一只手臂，但在随后的几周和几个月内，某些功能可能会恢复。这一改进可能是由于若干机制。然而，至少有一部分的改善可能是由于感觉运动皮层的重组。中风后，手臂的控制可能会被大脑中邻近的未受损区域接管。这种重组使令人印象深刻的功能恢复发生。我们有初步证据支持中风后外周神经（传入输入）产生的活动模式可能对大脑内组织变化的发展至关重要。我们已经证明，通过应用特定的感觉输入模式，我们能够在控制对象的运动皮层内产生组织变化。此外，我们已经能够在中风患者中诱导类似的变化。这些变化伴随着运动控制的改善。这些新颖而令人兴奋的发现支持了我们的假设，即通过将某些传入输入模式应用于中风后的患者，我们将能够通过最大化皮质内的再生来促进功能恢复。在本项目中，我们将建立中风患者大脑中的组织模式，并将研究结果与对照组进行对比。其次，我们将研究通过应用特定的传入输入模式来促进中风患者康复的潜力。这些新的实验可能会导致重要的治疗进展，这将有利于大量中风患者。

Specific regions of the human brain have been shown to reorganise following damage to the brain or peripheral nerves. This reorganisation is seen in both young and older subjects and is thought to be useful in helping to restore function. For example, following a stroke a patient may, initially, be unable to move one arm. However, in the following weeks and months some function may return. A number of mechanisms may be responsible for this improvement. However, it is likely that at least some of the improvement is due to reorganisation within the sensorimotor cortex. Following the stroke the control of the arm may be taken over by adjacent undamaged regions of the brain. This reorganisation allows impressive functional recoveries to occur. We have preliminary evidence to support the idea that patterns of activity generated in peripheral nerves (afferent input) following stroke may be crucial for the development of the organisational changes seen within the brain. We have shown that by applying specific patterns of sensory input we are able to produce organisational changes within the motor cortex of control subjects. Also, we have been able to induce similar changes in stroke patients. These changes have been accompanied by improvements in motor control. These novel and exciting findings support our hypothesis that by applying certain patterns of afferent input to patients following stroke we will be able to facilitate functional recovery by maximising reoganisation within the cortex. In the present project we will establish the organisation patterns in the brain of stroke patients and contrast the findings with control subjects. Secondly we will investigate the potential for facilitating recovery of stroke patients by the application of specific patterns of afferent input. These novel experiments may lead to important therapeutic developments that will benefit the large population of patients suffering strokes.