Teasell Robert, Bayona Nestor A, Bitensky Jamie
Department of Physical Medicine and Rehabilitation, St. Joseph's Health Care and the University of Western Ontario, London, Ontario, Canada.
Top Stroke Rehabil. 2005 Summer;12(3):11-26. doi: 10.1310/6AUM-ETYW-Q8XV-8XAC.
Reorganization of the cortex post stroke is dependent not only on the lesion site but also on remote brain areas that have structural connections with the area damaged by the stroke. Motor recovery is largely dependent on the intact cortex adjacent to the infarct, which points out the importance of preserving the penumbral areas. There appears to be a priority setting with contralateral and ipsilateral motor pathways, with ipsilateral (unaffected hemisphere) pathways only becoming prominent after more severe strokes where functional contralateral (affected hemisphere) pathways are unable to recover. Ipsilateral or unaffected hemisphere motor pathway activation is therefore associated with a worse prognosis.
中风后皮质的重组不仅取决于病变部位，还取决于与中风受损区域有结构连接的远隔脑区。运动恢复很大程度上取决于梗死灶附近完整的皮质，这凸显了保留半暗带区域的重要性。对侧和同侧运动通路似乎存在优先级设定，只有在更严重的中风导致对侧（患侧半球）功能通路无法恢复时，同侧（未受影响半球）通路才会变得突出。因此，同侧或未受影响半球运动通路的激活与更差的预后相关。
