Calgary Pediatric Stroke Program, Alberta Children's Hospital Research Institute, and Section of Neurology, Department of Pediatrics and Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Pediatr Neurol. 2013 Feb;48(2):81-94. doi: 10.1016/j.pediatrneurol.2012.08.001.
Perinatal stroke is presented as the ideal human model of developmental neuroplasticity. The precise timing, mechanisms, and locations of specific perinatal stroke diseases provide common examples of well defined, focal, perinatal brain injuries. Motor disability (hemiparetic cerebral palsy) constitutes the primary adverse outcome and the focus of models explaining how motor systems develop in health and after early injury. Combining basic science animal work with human applied technology (functional magnetic resonance imaging, diffusion tensor imaging, and transcranial magnetic stimulation), a model of plastic motor development after perinatal stroke is presented. Potential central therapeutic targets are revealed. The means to measure and modulate these targets, including evidence-based rehabilitation therapies and noninvasive brain stimulation, are suggested. Implications for clinical trials and future directions are discussed.
围产期卒中是发育神经可塑性的理想人类模型。特定围产期卒中疾病的精确时间、机制和位置为明确的、局灶性、围产期脑损伤提供了常见的范例。运动障碍（偏瘫性脑瘫）构成了主要的不良后果，也是解释运动系统在健康状态和早期损伤后如何发育的模型的重点。将基础科学动物工作与人类应用技术（功能磁共振成像、弥散张量成像和经颅磁刺激）相结合，提出了围产期卒中后运动发育的可塑性模型。揭示了潜在的中枢治疗靶点。提出了测量和调节这些靶点的方法，包括基于证据的康复治疗和非侵入性脑刺激。讨论了临床试验和未来方向的意义。
