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Recent studies in many different species have shown that peripheral or CNS damage early in life can affect subsequent brain development and lead to patterns of brain organization and function that differ greatly from normal.1 Impressive progress is occurring in understanding the nature of these reorganizations, and the mechanisms responsible for them are gradually emerging. At the same time, direct evidence that early lesions have similar effects in humans is limited, and the clinical implications of such effects are largely unknown. In this context, the study of Eyre et al.2 in this issue of Neurology is an important contribution.
Eyre et al.2 used transcranial magnetic stimulation (TMS) of motor cortex to evoke responses in trunk, arm, and hand muscles in normal subjects from birth to adulthood, in subjects with hemiplegic cerebral palsy, and in subjects with hemiplegia due to stroke at least 6 months earlier. Furthermore, they studied a group of normal neonates within 2 days of birth …
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