Evidence for a Window of Enhanced Plasticity in the Human Motor Cortex Following Ischemic Stroke

Background In preclinical models, behavioral training early after stroke produces larger gains compared with delayed training. The effects are thought to be mediated by increased and widespread reorganization of synaptic connections in the brain. It is viewed as a period spontaneous biological recovery during which plasticity increased. Objective To look for evidence similar change human brain weeks months ischemic stroke. Methods We used continuous theta burst stimulation (cTBS) activate synapses repeatedly motor cortex. This initiates stages that temporarily reduces cortical excitability motor-evoked potential amplitude. Thus, greater effect cTBS on potential, inferred level plasticity. Data were collected from separate cohorts (Australia UK). each cohort, serial measurements made following obtained ipsilesional cortex 31 survivors (Australia, 66.6 ± 17.8 years) over 12 contralesional 29 (UK, 68.2 9.8 6 months. Results Depression was most prominent shortly hemisphere diminished subsequent sessions ( P = .030). response did not differ across 12-month follow-up .903). Conclusions Our results provide first neurophysiological consistent enhanced Behavioral given this may especially effective supporting poststroke recovery.