This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
The human brain is capable of spontaneous recovery after stroke; this process can be accelerated and enhanced, provided that the appropriate treatments are undertaken in adequate amounts and at the right time. Ipsilateral motor cortex can modulate the plasticity of contralateral motor areas damaged by stroke.1 The paradigm for motor control therefore has shifted from strict cerebral localization to interactive functioning of cortical areas in both hemispheres, modulated by the changing balance of transcallosal inhibition.
Following a stroke, ipsilesional interhemispheric transcallosal inhibition decreases, resulting in 1) the unveiling or recruitment of structurally preexisting but functionally silent ipsilateral motor pathways from the unaffected hemisphere; and 2) unopposed inhibition of surviving motor pathways in the affected hemisphere.2 The recruitment of ipsilateral motor pathways from the unaffected hemisphere at the expense of inhibition of motor pathways in the affected hemisphere does not always herald a good recovery. Ipsilateral motor pathways have additional synapses, low fiber density, and little output to upper limb muscles; a poor motor outcome is more often seen in stroke patients who recover by ipsilateral pathways compared with those recovering through perilesional motor …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Long-term Safety and Efficacy of Avalglucosidase Alfa in Patients With Late-Onset Pompe Disease
Dr. Marianne de Visser and Dr. Maudy Theunissen