Darvish Mahmood Rajabtabar, Sung Joohwan, Williamson Jordan N, Mulyana Beni, Chen Xiaoxi, Yang Yuan
University of Illinois Urbana-Champaign, Grainger College of Engineering, Department of Bioengineering, Urbana, IL, USA.
Carle Foundation Hospital, Stephenson Family Clinical Research Institute, Clinical Imaging Research Center, Urbana, IL, USA.
Med Hypotheses. 2025 Jun;199. doi: 10.1016/j.mehy.2025.111653. Epub 2025 May 14.
Previous studies have found that post-stroke motor impairments are associated with damage to the lesioned corticospinal tract and the hyperexcitability of the cortico-reticulospinal tract at the hemisphere opposite to the lesion side, i.e., the contralesional hemisphere. While motor deficits and recovery mechanisms have been extensively studied, the role of sensory feedback in motor control has received less attention. We hypothesize that sensory-motor reorganization influences the stretch reflex and contributes to post-stroke spasticity. Effective motor function depends on the sensorimotor network, which integrates proprioceptive, tactile, and vibratory sensory inputs to guide movement and facilitate sensorimotor plasticity. Following stroke, these sensory pathways may undergo significant reorganization, leading to disrupted feedback loops and maladaptive changes in motor pathways. Recent studies have reported a hemispheric shift of somatosensory processing following a stroke. We propose to test our hypothesis by quantitatively analyzing the extent to which reorganization of sensory feedback pathways affects the stretch reflex. Testing our hypothesis will provide novel insights into the pathophysiological mechanisms underlying post-stroke spasticity. This will facilitate the development of customized rehabilitation strategies tailored to individual patient needs including improving their sensory feedback during movement exercise and other therapeutical intervention.
先前的研究发现，中风后的运动障碍与受损的皮质脊髓束损伤以及损伤侧对侧半球（即健侧半球）的皮质-网状脊髓束的过度兴奋有关。虽然运动缺陷和恢复机制已得到广泛研究，但感觉反馈在运动控制中的作用却较少受到关注。我们假设感觉运动重组会影响牵张反射，并导致中风后痉挛。有效的运动功能取决于感觉运动网络，该网络整合本体感觉、触觉和振动感觉输入以指导运动并促进感觉运动可塑性。中风后，这些感觉通路可能会发生显著重组，导致反馈回路中断和运动通路的适应不良变化。最近的研究报告了中风后体感处理的半球转移。我们建议通过定量分析感觉反馈通路的重组对牵张反射的影响程度来检验我们的假设。检验我们的假设将为中风后痉挛的病理生理机制提供新的见解。这将有助于制定针对个体患者需求的定制康复策略，包括在运动锻炼和其他治疗干预期间改善他们的感觉反馈。
