Relearning toward motor recovery in stroke, spinal cord injury, and cerebral palsy: a cognitive neural systems perspective.

In stroke, spinal cord injury, and cerebral palsy there is denervation of target neuron centers, which are self-organizing maps (SOMs) within the neuraxis. Compensatory reinnervation occurs within those SOMs by acquiring synaptic sprouts from whatever neurons in the neighborhood. Such reorganizations are more often maladaptive than beneficial. Motor recovery, if any appears, is incomplete and compromised. Cognitive systems studies indicate that motor paralysis is due to loss of learning <--> recall balance in those compensated SOMs, which had been locked into a stability <--> plasticity dilemma. Treatment/rehabilitation should aim therefore to first restore this learning related balance. The use of botulinum toxin as a neuromotor relearning tool to improve motor recovery is discussed.