Ward N S
Wellcome Trust Centre for Neuroimaging, Institute of Neurology, London, UK.
Eura Medicophys. 2007 Jun;43(2):285-94. Epub 2007 May 28.
Neurological damage and stroke in particular is the leading cause of long-term disability worldwide. Recovery of function after stroke is a consequence of many factors including resolution of oedema and survival of the ischaemic penumbra. In addition, there is a growing interest in how reorganisation of the surviving tissue might subserve the improvements in function that are commonly seen over weeks, months, and sometimes years after stroke. Noninvasive techniques such as functional magnetic resonance imaging, electroencephalography, magnetoencephalography and transcranial magnetic stimulation allow the study of this reorganisation in humans. Currently, results suggest that functionally relevant reorganisation does occur in cerebral networks in human stroke patients. This reorganisation can only occur in structurally and functionally intact brain regions. Because these vary depending on the location of the infarction, it is likely that different therapeutic strategies will be required to promote reorganisation depending on residual functional anatomy. This review maps out the attempts to describe functionally relevant adaptive changes in the human brain following focal damage. A greater understanding of how these changes are related to the recovery process will facilitate the development of novel therapeutic techniques designed to minimise impairment based on neurobiological principles and how to target these treatments to individual patients.
神经损伤，尤其是中风，是全球长期残疾的主要原因。中风后功能的恢复是多种因素共同作用的结果，包括水肿的消退和缺血半暗带的存活。此外，人们越来越关注存活组织的重组如何促进中风后数周、数月甚至数年常见的功能改善。诸如功能磁共振成像、脑电图、脑磁图和经颅磁刺激等非侵入性技术使得在人类身上研究这种重组成为可能。目前，研究结果表明，人类中风患者的大脑网络中确实发生了功能相关的重组。这种重组只能发生在结构和功能完整的脑区。由于这些脑区因梗死部位的不同而不同，因此可能需要根据残余功能解剖结构采取不同的治疗策略来促进重组。这篇综述梳理了描述局灶性损伤后人类大脑中功能相关适应性变化的尝试。更深入地了解这些变化与恢复过程之间的关系，将有助于开发基于神经生物学原理的旨在最小化损伤的新型治疗技术，以及如何针对个体患者进行这些治疗。
