Functional reorganization of reticulospinal drive in hemiparetic stroke

网状脊髓通路可能是双侧残疾和康复的关键因素， 仍然是被低估的。 这项建议通过整合神经解剖学， 神经生理学和行为领域。网状脊髓束接受来自 半球和项目双边，并经历神经解剖学的变化，在慢性 偏瘫性中风神经生理学上，阿尔法波段（10-20赫兹）神经驱动被夸大或 中风后，神经驱动的频率在双臂肌肉中重新分布， 被认为是网状脊髓的，而不是皮质脊髓的，起源。我们将其与行为联系起来， 神经驱动在参与病理协同作用的肌肉中尤其加剧， 扰乱运动控制 我们将证明肌肉-肌肉连贯性是一种有效的神经生理学检测， 在网状脊髓束水平表征双侧运动障碍的机制。 利用这些机制进行干预，以恢复受影响更严重的手臂， 有机会恢复和促进大脑修复，而不仅仅是通过 补偿策略的实践。

Reticulospinal pathways are likely key contributors to bilateral disability and recovery that remain understudied. This proposal breaks new conceptual ground by integrating across neuroanatomical, neurophysiological & behavioral domains in stroke. The reticulospinal tract receives input from both hemi-spheres and projects bilaterally, and undergoes neuroanatomical changes in chronic hemiparetic stroke. Neurophysiologically, alpha-band (10-20 Hz) neural drive is exaggerated or redistributed across muscles of both arms after stroke, and this frequency of neural drive is thought to be of reticulospinal, but not corticospinal, origin. We link this to behavior as alpha-band neural drive is especially exacerbated in muscles involved in the pathologic synergies that disrupt motor control. We will demonstrate muscle-muscle coherence is a valid neurophysiological assay to characterize mechanisms of bilateral motor impairment at the level of the reticulospinal tract. Interventions exploiting these mechanisms for recovery of the more-affected arm have a greater chance at being restorative and promoting brain repair than simply improving function through practice of compensatory strategies.