Neuroplasticity and Neurorehabilitation Doctoral Training Programme, NeuroRehabilitation Unit, Department of Health and Nursing, College of Applied Health and Communities, University of East London, Stratford Campus, Water Lane, London E15 4LZUK.
UCLP Centre for Neurorehabilitation, UCL Institute of Neurology, University College London, Gower Street, London WC1E 6BT, UK.
Rev Neurosci. 2019 Jul 26;30(6):605-623. doi: 10.1515/revneuro-2018-0082.
Recovery from a stroke is a dynamic time-dependent process, in which the central nervous system reorganises to accommodate for the impact of the injury. The purpose of this paper is to review recent longitudinal studies of changes in brain connectivity after stroke. A systematic review of research papers reporting functional or effective connectivity at two or more time points in stroke patients was conducted. Stroke leads to an early reduction of connectivity in the motor network. With recovery time, the connectivity increases and can reach the same levels as in healthy participants. The increase in connectivity is correlated with functional motor gains. A new, more randomised pattern of connectivity may then emerge in the longer term. In some instances, a pattern of increased connectivity even higher than in healthy controls can be observed, and is related either to a specific time point or to a specific neural structure. Rehabilitation interventions can help improve connectivity between specific regions. Moreover, motor network connectivity undergoes reorganisation during recovery from a stroke and can be related to behavioural recovery. A detailed analysis of changes in connectivity pattern may enable a better understanding of adaptation to a stroke and how compensatory mechanisms in the brain may be supported by rehabilitation.
中风后的恢复是一个动态的、依赖时间的过程，在此过程中，中枢神经系统会进行重组以适应损伤的影响。本文旨在回顾最近关于中风后大脑连接变化的纵向研究。对报告中风患者在两个或更多时间点的功能或有效连接的研究论文进行了系统回顾。中风会导致运动网络的早期连接减少。随着恢复时间的延长，连接增加，并可达到与健康参与者相同的水平。连接的增加与功能运动增益相关。在更长的时间内，可能会出现一种新的、更随机的连接模式。在某些情况下，甚至可以观察到比健康对照组更高的连接模式，这与特定的时间点或特定的神经结构有关。康复干预措施可以帮助改善特定区域之间的连接。此外，运动网络的连接在中风后的恢复过程中会发生重组，并与行为恢复相关。对连接模式变化的详细分析可能有助于更好地理解对中风的适应，以及大脑中的代偿机制如何通过康复得到支持。
