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Neural Plasticity
Volume 2012, Article ID 970136, 10 pages
Review Article

Plasticity of Adult Sensorimotor System in Severe Brain Infarcts: Challenges and Opportunities

1School of Psychology, University of Surrey, Guildford GU2 7XH, UK
2Neurology Clincal Division, Hospital das Clinicas, São Paulo University, 05403-000 São Paulo, SP, Brazil
3Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, 05652-900 São Paulo, SP, Brazil

Received 4 December 2011; Accepted 9 January 2012

Academic Editor: Jacques-Olivier Coq

Copyright © 2012 Annette Sterr and Adriana Bastos Conforto. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Functional reorganization forms the critical mechanism for the recovery of function after brain damage. These processes are driven by inherent changes within the central nervous system (CNS) triggered by the insult and further depend on the neural input the recovering system is processing. Therefore these processes interact with not only the interventions a patient receives, but also the activities and behaviors a patient engages in. In recent years, a wide range of research programs has addressed the association between functional reorganization and the spontaneous and treatment-induced recovery. The bulk of this work has focused on upper-limb and hand function, and today there are new treatments available that capitalize on the neuroplasticity of the brain. However, this is only true for patients with mild to moderated impairments; for those with very limited hand function, the basic understanding is much poorer and directly translates into limited treatment opportunities for these patients. The present paper aims to highlight the knowledge gap on severe stroke with a brief summary of the literature followed by a discussion of the challenges involved in the study and treatment of severe stroke and poor long-term outcome.