Role of the Contralesional vs. Ipsilesional Hemisphere in Stroke Recovery
Following a stroke, the resulting lesion creates contralateral motor impairment and an interhemispheric imbalance involving hyperexcitability of the contralesional hemisphere. Neuronal reorganization may occur on both the ipsilesional and contralesional hemispheres during recovery to regain motor fu...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2017-09-01
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| Series: | Frontiers in Human Neuroscience |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fnhum.2017.00469/full |
| _version_ | 1811208341903376384 |
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| author | Keith C. Dodd Veena A. Nair Vivek Prabhakaran Vivek Prabhakaran Vivek Prabhakaran Vivek Prabhakaran Vivek Prabhakaran |
| author_facet | Keith C. Dodd Veena A. Nair Vivek Prabhakaran Vivek Prabhakaran Vivek Prabhakaran Vivek Prabhakaran Vivek Prabhakaran |
| author_sort | Keith C. Dodd |
| collection | DOAJ |
| description | Following a stroke, the resulting lesion creates contralateral motor impairment and an interhemispheric imbalance involving hyperexcitability of the contralesional hemisphere. Neuronal reorganization may occur on both the ipsilesional and contralesional hemispheres during recovery to regain motor functionality and therefore bilateral activation for the hemiparetic side is often observed. Although ipsilesional hemispheric reorganization is traditionally thought to be most important for successful recovery, definitive conclusions into the role and importance of the contralesional motor cortex remain under debate. Through examining recent research in functional neuroimaging investigating motor cortex changes post-stroke, as well as brain-computer interface (BCI) and transcranial magnetic stimulation (TMS) therapies, this review attempts to clarify the contributions of each hemisphere toward recovery. Several functional magnetic resonance imaging studies suggest that continuation of contralesional hemisphere hyperexcitability correlates with lesser recovery, however a subset of well-recovered patients demonstrate contralesional motor activity and show decreased functional capability when the contralesional hemisphere is inhibited. BCI therapy may beneficially activate either the contralesional or ipsilesional hemisphere, depending on the study design, for chronic stroke patients who are otherwise at a functional plateau. Repetitive TMS used to excite the ipsilesional motor cortex or inhibit the contralesional hemisphere has shown promise in enhancing stroke patients' recovery. |
| first_indexed | 2024-04-12T04:19:31Z |
| format | Article |
| id | doaj.art-fe9afce46a8745a9813b3bc3894606bf |
| institution | Directory Open Access Journal |
| issn | 1662-5161 |
| language | English |
| last_indexed | 2024-04-12T04:19:31Z |
| publishDate | 2017-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Human Neuroscience |
| spelling | doaj.art-fe9afce46a8745a9813b3bc3894606bf2022-12-22T03:48:17ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612017-09-011110.3389/fnhum.2017.00469279403Role of the Contralesional vs. Ipsilesional Hemisphere in Stroke RecoveryKeith C. Dodd0Veena A. Nair1Vivek Prabhakaran2Vivek Prabhakaran3Vivek Prabhakaran4Vivek Prabhakaran5Vivek Prabhakaran6Department of Biomedical Engineering, University of Wisconsin-MadisonMadison, WI, United StatesDepartment of Radiology, School of Medicine and Public Health, University of Wisconsin-MadisonMadison, WI, United StatesDepartment of Radiology, School of Medicine and Public Health, University of Wisconsin-MadisonMadison, WI, United StatesMedical Scientist Training Program, School of Medicine and Public Health, University of Wisconsin—MadisonMadison, WI, United StatesNeuroscience Training Program, University of Wisconsin—MadisonMadison, WI, United StatesDepartment of Neurology, University of Wisconsin—MadisonMadison, WI, United StatesDepartment of Psychology and Department of Psychiatry, University of Wisconsin—MadisonMadison, WI, United StatesFollowing a stroke, the resulting lesion creates contralateral motor impairment and an interhemispheric imbalance involving hyperexcitability of the contralesional hemisphere. Neuronal reorganization may occur on both the ipsilesional and contralesional hemispheres during recovery to regain motor functionality and therefore bilateral activation for the hemiparetic side is often observed. Although ipsilesional hemispheric reorganization is traditionally thought to be most important for successful recovery, definitive conclusions into the role and importance of the contralesional motor cortex remain under debate. Through examining recent research in functional neuroimaging investigating motor cortex changes post-stroke, as well as brain-computer interface (BCI) and transcranial magnetic stimulation (TMS) therapies, this review attempts to clarify the contributions of each hemisphere toward recovery. Several functional magnetic resonance imaging studies suggest that continuation of contralesional hemisphere hyperexcitability correlates with lesser recovery, however a subset of well-recovered patients demonstrate contralesional motor activity and show decreased functional capability when the contralesional hemisphere is inhibited. BCI therapy may beneficially activate either the contralesional or ipsilesional hemisphere, depending on the study design, for chronic stroke patients who are otherwise at a functional plateau. Repetitive TMS used to excite the ipsilesional motor cortex or inhibit the contralesional hemisphere has shown promise in enhancing stroke patients' recovery.http://journal.frontiersin.org/article/10.3389/fnhum.2017.00469/fullipsilesionalcontralesionalstrokemotor recoverybrain-computer interfacetranscranial magnetic stimulation |
| spellingShingle | Keith C. Dodd Veena A. Nair Vivek Prabhakaran Vivek Prabhakaran Vivek Prabhakaran Vivek Prabhakaran Vivek Prabhakaran Role of the Contralesional vs. Ipsilesional Hemisphere in Stroke Recovery Frontiers in Human Neuroscience ipsilesional contralesional stroke motor recovery brain-computer interface transcranial magnetic stimulation |
| title | Role of the Contralesional vs. Ipsilesional Hemisphere in Stroke Recovery |
| title_full | Role of the Contralesional vs. Ipsilesional Hemisphere in Stroke Recovery |
| title_fullStr | Role of the Contralesional vs. Ipsilesional Hemisphere in Stroke Recovery |
| title_full_unstemmed | Role of the Contralesional vs. Ipsilesional Hemisphere in Stroke Recovery |
| title_short | Role of the Contralesional vs. Ipsilesional Hemisphere in Stroke Recovery |
| title_sort | role of the contralesional vs ipsilesional hemisphere in stroke recovery |
| topic | ipsilesional contralesional stroke motor recovery brain-computer interface transcranial magnetic stimulation |
| url | http://journal.frontiersin.org/article/10.3389/fnhum.2017.00469/full |
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