Motor recovery mechanisms in patients with middle cerebral artery infarct: a mini-review.

Previous studies on the mechanisms of motor recovery in patients with middle cerebral artery (MCA) infarct except for the studies on cortical peri-infarct reorganization after primary motor cortex infarct were reviewed. Eight studies were classified and reviewed by the following four motor recovery mechanisms: contribution of premotor cortex, subcortical peri-infarct reorganization, ipsilateral motor pathway, and contribution of aberrant motor pathway. MCA infarct is the most common type among the arterial territory infarcts. In addition, MCA territory is important for motor function because it comprises the corticospinal tract, the corticoreticulospinal tract and the neural tracts which are related with apraxia (superior longitudinal fasciculus and corticofugal fibers from the premotor cortex). In spite of the significance of the MCA territory for motor function, fewer studies have reported on the mechanisms of motor recovery in MCA infarct compared to total number of studies about cerebral infarct. In addition, the majority of these studies have focused on the corticospinal tract. Therefore, the total number of studies on this topic should be increased. We believe that further studies comprising other neural tracts except for the corticospinal tract including the extrapyramidal tracts such as the corticoreticulospinal and neural tracts which are related with apraxia, are necessary.