Review Article

Maladaptive Plasticity for Motor Recovery after Stroke: Mechanisms and Approaches

Figure 1

Maladaptive plasticity induced by disinhibition of motor-related areas in stroke patients. (a) Localized disinhibition in the ipsilesional primary motor cortex (M1). Localized disinhibition in the ipsilesional M1 promotes motor recovery by facilitating neural plasticity without competitive interaction between hand and proximal arm. (b) Widespread disinhibition in the ipsilesional M1 and premotor cortex (PMC). The disinhibition in the ipsilesional PMC causes uneven excitability distribution in the proximal arm and proximal-dominant competitive interaction in the ipsilesional M1 and PMC. As a result, this widespread disinhibition induces maladaptive plasticity that poorly controls the paretic hand in stroke patients.
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(a)
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(b)