Experience, Cortical Remapping, and Recovery in Brain Disease

Neurobiol Dis, 2010 · DOI: 10.1016/j.nbd.2009.09.007 · Published: February 1, 2010

Stroke Recovery Neurology Neurorehabilitation

Simple Explanation

Recovery from brain disorders involves changes in undamaged neurons, a process called plasticity. Brain areas are mapped for sensory and motor functions, and these maps can change with experience, especially after injury. After a stroke, spared areas of the brain's motor map can start representing affected body parts, with this expansion depending on experience.

Study Duration

Not specified

Participants

Human stroke survivors and animal models

Evidence Level

Review article

Key Findings

1
Experience-dependent processes, including disinhibition and synapse stabilization, are crucial for recovery after CNS injury.
2
TMS mapping reveals that motor maps evolve during recovery, with map expansion correlating with improved motor ability in stroke patients.
3
In dysmelia patients, fMRI showed representation of foot movement on the expected hand representation, suggesting the motor representation has developmental limits.

Research Summary

Recovery from brain and spinal cord disorders is an area of active research that seeks to maximize improvement after neuronal damage. Brain maps, particularly motor maps, are reorganized after injury, and this reorganization is influenced by experience and rehabilitation strategies. While remapping is important, the concept of remapping has led to an exaggerated conception of post-lesion plasticity.

Practical Implications

Rehabilitation Strategies

Rehabilitative strategies should focus on experience-dependent plasticity to maximize recovery after brain injury.

Understanding Motor Maps

Understanding motor map reorganization is crucial for developing targeted therapies, such as epidural stimulation.

Limitations of Remapping

Recognizing the limits of brain remapping is important for setting realistic expectations for recovery, especially in cases of congenital brain disorders.

Study Limitations

1
The fine structure of motor representations may not be somatotopically well-ordered.
2
Non-invasive techniques have limited access to the fine structure of maps compared to invasive electrophysiological methods.
3
Changes observed in TMS maps may result from multiple factors, including changes in inhibition, excitability, and spinal cord circuitry, and may not fully represent cortical remapping.

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