Neurological damage and stroke in particular, is the leading cause of long term disability worldwide. In just the last two decades, science has begun to appreciate the central nervous system's attempts to repair itself through a process termed neuroplasticity. Recent advances in non-invasive functional neuroimaging techniques, such as positron emission tomography (PET), functional MRI (fMRI) and near-infrared spectroscopy (NIRS), have enabled the study of brain activity in humans after stroke. Presented in brief are landmark papers that describe how adaptive changes occur in the human brain after focal neurological damage. These changes are thought to be due to re-organisation of neural networks following the brain injury and are thought to play a role in recovery of function following stroke.
Cross-sectional studies at chronic stages of stroke have demonstrated that the pattern of brain activation is different between paretic and normal hand movements, and suggested that long-term recovery is facilitated by compensation, recruitment and reorganization of cortical motor function in both damaged and non-damaged hemispheres (Chollet et al., 1991; Weiller et al., 1992; Cramer et al., 1997; Cao et al., 1998; Ward et al., 2003a).
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Subsequent longitudinal studies from subacute to chronic stages (before and after rehabilitation following intensive physical and occupational therapy) have revealed a dynamic, bihemispheric reorganization of motor network. (Marshall et al., 2000; Calautti et al., 2001; Feydy et al., 2002; Ward et al, 2003b).
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