Brain networks and their relevance for stroke rehabilitation

Abstract

Stroke has long been regarded as focal disease with circumscribed damage leading to neurological deficits. However, advances in methods for assessing the human brain and in statistics have enabled new tools for the examination of the consequences of stroke on brain structure and function. Thereby, it has become clear that stroke has impact on the entire brain and its network properties and can therefore be considered as a network disease. The present review first gives an overview of current methodological opportunities and pitfalls for assessing stroke-induced changes and reorganization in the human brain. We then summarize principles of plasticity after stroke that have emerged from the assessment of networks. Thereby, it is shown that neurological deficits do not only arise from focal tissue damage but also from local and remote changes in white-matter tracts and in neural interactions among widespread networks. Similarly, plasticity and clinical improvements are associated with specific compensatory structural and functional patterns of neural network interactions. Innovative treatment approaches have started to target such network patterns to enhance recovery. Network assessments to predict treatment response and to individualize rehabilitation is a promising way to enhance specific treatment effects and overall outcome after stroke.

Neurostimulation and Reach-to-Grasp Function Recovery Following Acquired Brain Injury: Insight From Pre-clinical Rodent Models and Human Applications

“…Spontaneous reorganization mainly occurs within the first 3 months post-stroke in humans, a critical time period in which heightened plasticity can be exploited to facilitate recovery ( 114 ). The recent advances in brain connectivity analyses have led to a greater emphasis on understanding remote effects of the infarct on large-scale brain network structure ( 115 – 119 ). A meta-analysis found that across a wide variety of motor tasks and impairments, stroke patients exhibit higher activation in primary motor cortex opposite the lesioned hemisphere, as well as increased bilateral premotor activity relative to healthy controls ( 120 ).…”

Introductory Chapter: The “DNA Model” of Neurosciences and Computer Systems

“…Innovations have demonstrated the use of brain waves and software recreated from a biological system, to enhance modern medicine for better diagnostic and treatment possibilities. As reviewed by Guggisberg, Koch's [10] probabilistic tractography algorithms can be used to determine the extent of damage to neuronal connectivity following a stroke episode among other rehabilitative techniques such as repetitive transcranial electric stimulation. Of interest, EEG-based BCI architecture has been a tremendous asset in patients suffering from neuromuscular disorders, hence facilitation of simple movement/locomotor remission aided by neuro-prosthetics.…”

Optogenetics in Brain Research: From a Strategy to Investigate Physiological Function to a Therapeutic Tool

“…In the following section, we will introduce recent studies that exploited optogenetics as a treatment and rehabilitation strategy compared to other low-or non-invasive brain stimulation techniques (NIBS). Indeed, NIBS like transcranial Electrical Stimulation (tES) or Transcranial Magnetic Stimulation (TMS) demonstrated promising results in post-stroke recovery, anxiety, and depression treatment, in addition to improving Parkinson's symptoms in human patients [102][103][104][105][106][107][108][109]. Nevertheless, these methods are non-selective and limited by the low spatial resolution, which induces activity changes of all cell types near the stimulated site.…”