Combinations of stroke neurorehabilitation to facilitate motor recovery: Perspectives on Hebbian plasticity and homeostatic metaplasticity

Naoyuki Takeuchi, Shin Ichi Izumi

研究成果: Article査読

38 被引用数 (Scopus)

抄録

Motor recovery after stroke involves developing new neural connections, acquiring new functions, and compensating for impairments. These processes are related to neural plasticity. Various novel stroke rehabilitation techniques based on basic science and clinical studies of neural plasticity have been developed to aid motor recovery. Current research aims to determine whether using combinations of these techniques can synergistically improve motor recovery. When different stroke neurorehabilitation therapies are combined, the timing of each therapeutic program must be considered to enable optimal neural plasticity. Synchronizing stroke rehabilitation with voluntary neural and/or muscle activity can lead to motor recovery by targeting Hebbian plasticity. This reinforces the neural connections between paretic muscles and the residual motor area. Homeostatic metaplasticity, which stabilizes the activity of neurons and neural circuits, can either augment or reduce the synergic effect depending on the timing of combination therapy and types of neurorehabilitation that are used. Moreover, the possibility that the threshold and degree of induced plasticity can be altered after stroke should be noted. This review focuses on the mechanisms underlying combinations of neurorehabilitation approaches and their future clinical applications. We suggest therapeutic approaches for cortical reorganization and maximal functional gain in patients with stroke, based on the processes of Hebbian plasticity and homeostatic metaplasticity. Few of the possible combinations of stroke neurorehabilitation have been tested experimentally; therefore, further studies are required to determine the appropriate combination for motor recovery.

本文言語English
論文番号349
ジャーナルFrontiers in Human Neuroscience
9
JUNE
DOI
出版ステータスPublished - 2015 6月 23

ASJC Scopus subject areas

  • 神経心理学および生理心理学
  • 神経学
  • 精神医学および精神衛生
  • 生物学的精神医学
  • 行動神経科学

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