Changes in Motoneurone and Motor Axon Properties Distal to the Lesion in Stroke

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Following a stroke, adaptive changes occur in spinal cord motoneurones below the level of the stroke, but these are poorly understood. Apart from the exaggeration of spinal reflexes, distal changes have largely been neglected by clinicians. Even the mechanisms responsible for the exaggeration of spinal reflexes are still debated, in part because no single process can account for it. Using novel experimental techniques originally developed to study biophysical properties of human peripheral nerves, this project will quantify the changes in excitability that occur in motoneurones and their peripheral extension, the motor axon, and compare these with the findings on the non-paralysed side of the same patients and with healthy matched control subjects. The changes that occur over time will be documented in longitudinal studies. The findings will be correlated with the patient's clinical status, providing insight into the extent to which changes in motoneurone properties drive clinical manifestations such as spasticity. In addition, control studies will provide further insight into whether disturbed transmission in some specific spinal reflex pathways contributes significantly to spasticity. The project is important for understanding the nature of adaptive changes (plasticity) in neural structures following lesions in the central nervous system and will shed light on the remote changes that occur in stroke. The studies are relevant not only for understanding current deficits but also for understanding and perhaps altering outcomes using rehabilitation procedures.