Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Poststroke neuroplasticity processes

Full Text:


The paper considers different aspects of neuroplasticity in patients with stroke. It underlines the dynamism of this process and the ambiguity of involvement of the structures of the contralateral cerebral hemisphere in the restorative process. It considers the periods after onset of stroke and the activation of different brain regions (of both the involved and intact hemisphere) in the poststroke period. Particular emphasis is placed on the issues of neurorehabilitation in this category of patients. Delay in rehabilitation measures leads to a worse outcome, the patients must be at hospital longer. It is emphasized that the neurorehabilitaton measures should use strategies aimed at improving plasticity processes at the level of synaptic transmission and neuronal communications. At the same time, of great importance are the processes of structural and functional remodeling of neuronal communications with the involvement of surviving neurons that are located in the peri-infarct area and partially damaged during ischemia. To recover stroke-induced lost motor functions, measures are implemented to modulate the ipsilateral motor cortex, contralateral motor cortex, and sensory afferentation. Remodeling processes, one of the manifestations of neuroplasticity, vary with the size and location of an ischemic focus. The specific features of this process with subcortical and cortical foci are considered. It is stressed that there are genetically determined neurotrophic factors that may enhance remodeling processes in the peri-infarct area, as well as factors that inhibit these processes. The sensory system is noted to have a high potential of compensation, which is appreciably associated with the considerable extent of sensory fibers even at the level of the cerebral cortex.

About the Authors

I. V. Damulin
Department of Nervous System Diseases and Neurosurgery, Faculty of Therapeutics Research Center, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Moscow 119021

E. V. Ekusheva
Reseach Department of Neurology, Research Center, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Moscow 119021


1. Wissel J, Olver J, Stibrant Sunnerhagen K. Navigating the poststroke continuum of care. J Stroke Cerebrovasc Dis. 2013;22(1):1–8. DOI: 2011.05.021.

2. Riley JD, Le V, Der-Yeghiaian L, et al. Anatomy of stroke injury predicts gains from therapy. Stroke. 2011;42(2):421–6. DOI: 110.599340.

3. Гусев ЕИ, Скворцова ВИ. Ишемия головного мозга. Москва: Медицина; 2001. 328 с. [Gusev EI, Skvortsova VI. Ishemiya golovnogo mozga [Brain ischemia]. Moscow: Meditsina; 2001. 328 p.]

4. Byl N, Roderick J, Mohamed O, et al. Effectiveness of sensory and motor rehabilitation of the upper limb following the principles of neuroplasticity: patients stable poststroke. Neuroreabil Neural Repair. 2003;17(3):176–91. DOI: 0888439003257137.

5. Dobkin BH. Rehabilitation after stroke. New Engl J Med. 2005;352:1677–84. DOI:

6. Murphy TH, Corbett D. Plasticity during stroke recovery: from synapse to behaviour. Nature Rev Neurosci. 2009;10:861–72. DOI:

7. Cummings JL, Trimble MR. Concise guide to neuropsychiatry and behavioral neurology. 2nd ed. Washington, London: American Psychiatric Publishing, Inc; 2002. 275 p.

8. Кадыков АС, Шахпаронова НВ. Реабилитация после инсульта. Русский медицинский журнал. 2003;11(25):1390–4. [Kadykov AS, Shakhparonova NV. Rehabilitation after a stroke. Russkii meditsinskii zhurnal. 2003;11(25):1390–4. (In Russ.)]

9. Leipert J. Pharmacotherapy in restorative neurology. Curr Opin Neurol. 2008;21:639–43. DOI:

10. Miller E, Murray L, Richards L, et al. Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: a scientific statement from the American Heart Association. Stroke. 2010;41:2402–48.DOI: 0b013e3181e7512b.

11. Wolf SL, Winstein CJ, Miller JP, et al. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. JAMA. 2006;296:2095–104. DOI:

12. Broeks JG, Lankhorst GJ, Rumping K, Prevo AJ. The long-term outcome of arm function after stroke: results of a follow-up study. Disabil Rehabil. 1999;21(8):357–64. DOI:

13. Mohan KM, Wolfe CD, Rudd AD, et al. Risk and cumulative risk of stroke recurrence. A systematic review and meta-analysis. Stroke. 2011;42:1489–94. DOI: 110.602615.

14. Стаховская ЛВ, Скворцова ВИ, Чазова ИЕ. Вторичная профилактика ишемического инсульта. Consilium Medicum. 2003;5(8):473–6. [Stakhovskaya LV, Skvortsova VI, Chazova IE. Secondary prevention of an ischemic stroke. Consilium Medicum. 2003;5(8):473–6. (In Russ.)]

15. Танашян ММ, Домашенко МА. Вторичная медикаментозная профилактика ишемического инсульта. Consilium Medicum. 2006;8(8):86–91. [Tanashyan MM, Domashenko MA. Secondary medicamentous prevention of an ischemic stroke. Consilium Medicum. 2006;8(8):86–91. (In Russ.)]

16. Vaughan CJ, Delanty N. Hypertensive emergencies. Lancet. 2000;356:411–7. DOI:

17. Dancause N. Vicarious function of remote cortex following stroke: recent evidence from human and animal studies. Neuroscientist. 2006;12(6):489–99. DOI: 1073858406292782.

18. Del Zoppo GJ. Stroke and endovascular protection. N Engl J Med. 2006;354(6):353–5. DOI:

19. Скворцова ВИ. Реперфузионная терапия ишемического инсульта. Consilium Medicum. 2004;6(8):610–4. [Skvortsova VI. Reperfusion therapy of an ischemic stroke. Consilium Medicum. 2004;6(8):610–4. (In Russ.)]

20. Суслина ЗА, Максимова МЮ, Федорова ТН. Оксидантный стресс и основные направления нейропротекции при нарушениях мозгового кровообращения. Неврологический журнал. 2007;12(4):3–7. [Suslina ZA, Maksimova MYu, Fedorova TN. Oxidative stress and the principal directions of neuroprotection in patients with stroke. Nevrologicheskii zhurnal. 2007;12(4):3–7. (In Russ.)]

21. Парфенов ВА. Постинсультная депрессия: распространенность, патогенез, диагностика и лечение. Неврология, нейропсихиатрия, психосоматика. 2012;(4):84–8. [Parfenov VA. Poststroke depression: prevalence, pathogenesis, diagnosis, and treatment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(4):84–8. (In Russ.)]. DOI:

22. Chong JY, Lee H-S, Boden-Albala B, et al. Gender differences in self-report of recovery after stroke: The Northern Manhattan Study. Neurology. 2006;67:1282–4. DOI: 0000238161.71591.e9.

23. De Haan EH, Nys GM, van Zandvoort MJ. Cognitive function following stroke and vascular cognitive impairment. Curr Opin Neurol. 2006;19:559–64. DOI: 0000247612.21235.d9.

24. Cumming TB, Marshall RS, Lazar RM. Stroke, cognitive deficits, and rehabilitation: still an incomplete picture. Internat J Stroke. 2013;8:38–45. DOI: 4949.2012.00972.x.

25. Гусев ЕИ, Камчатнов ПР. Пластичность нервной системы. Журнал неврологии и психиатрии им. С.С. Корсакова. 2004;104(3):73–9. [Gusev EI, Kamchatnov PR. Plasticity of nervous system. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2004;104(3):73–9. (In Russ.)]

26. Екушева ЕВ, Дамулин ИВ. Реабилитация после инсульта: значение процессов нейропластичности и сенсомоторной интеграции. Журнал неврологии и психиатрии им. С.С. Корсакова. 2013;113(12–2):35–41. [Ekusheva EV, Damulin IV. Rehabilitation after stroke: the role of neuroplasticity and sensorimotor integration. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2013;113(12–2):35–41. (In Russ.)]

27. Проказова ПР, Пирадов МА, Рябинкина ЮВ и др. Роботизированная механотерапия с использованием тренажера MOTOmed letto2 в комплексной ранней реабилитации больных с инсультом в отделении реанимации и интенсивной терапии. Анналы клинической и экспериментальной неврологии. 2013;7(2):11–5. [Prokazova PR, Piradov MA, Ryabinkina YuV, et al. The robotized mechanotherapy with MOTOmed letto2 exercise machine use in complex early rehabilitation of patients with a stroke in office of reanimation and intensive therapy. Annaly klinicheskoi i eksperimental'noi nevrologii. 2013;7(2):11–5. (In Russ.)]

28. Korner-Bitensky N. When does stroke rehabilitation end? Int J Stroke. 2013;8(1):8–10. DOI: 10.1111/j.1747-4949.2012.00963.x.

29. Bernhardt J, Indredavik B, Langhorne P. When should rehabilitation begin after stroke? Int J Stroke. 2013;8(1):5–7. DOI:

30. Dromerick AW, Lang CE, Birkenmeier RL, et al. Very early constraint-induced movement during stroke rehabilitation (VECTORS): a single-center RCT. Neurology. 2009;73:195–201. DOI: 1212/WNL.0b013e3181ab2b27.

31. Oujamaa L, Relave I, Froger J, et al. Rehabilitation of arm function after stroke. Literature review. Ann Phisical Rehabilit Med. 2009;52:269–93. DOI:

32. Van Spronsen M, Hoogenraad C. Synapse pathology in psychiatric and neurologic disease.Curr Neurol Neurosci Rep. 2010;10:207–14. DOI:

33. Гехт АБ, Бурд ГС, Селихова МВ и др. Нарушения мышечного тонуса и их лечение сирдалудом у больных в раннем восстановительном периоде ишемического инсульта. Журнал неврологии и психиатрии им. С.С. Корсакова. 1998;98(10):22–9. [Gekht AB, Burd GS, Selikhova MV, et al. Violations of a muscular tone and their treatment sirdaludy at patients in the early recovery period of an ischemic stroke. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 1998;98(10):22–9. (In Russ.)]

34. Moller AR. Neural plastisity and disorders of the nervous system. Cambridge etc.: Cambridge University Press; 2006. 394 p. DOI:

35. Rijntjes M. Mechanisms of recovery in stroke patients with hemiparesis or aphasia: new insights, old questions and the meaning of therapies. Curr Opin Neurol. 2006;19(1):76–83. DOI: wco.0000203886.28068.38.

36. Onishi H, Sugawara K, Yamashiro K, et al. Neuromagnetic activation following active and passive finger movements. Brain Behav. 2013;3(2):178–92. DOI: 10.1002/brb3.126. Epub 2013 Feb 17.

37. Donkelaar HJ, Lammens M, Wesseling P, et al. Development and malformations of the human pyramidal tract. J Neurol. 2004;251:1429–42. DOI:

38. Bastian J, Nguyenkim J. Dendritic modulation of burst-like firing in sensory neurons. J Neurophisiol. 2001;85(1):10–22.

39. Nudo RJ, Friel KM, Delia SW. Role of sensory deficits in motor impairments after injury to primary motor cortex. Neuropharmacol. 2000;39:733–42. DOI:

40. Scalha TВ, Miyasaki Е, Lima NM, Borges G. Correlations between motor and sensory functions in upper limb chronic hemiparetics after stroke. Arq Neuropsiquiatr. 2011;69(4):624–9. DOI:

41. Carey LM, Abbott DF, Egan GF, et al. Evaluation of brain activation with good and poor motor recovery after stroke. Neurorehabil Neural Repair. 2006;20(1):24–41. DOI:

42. Voytek B, Davis M, Yago E, et al. Dynamic neuroplasticity after human prefrontal cortex damage. Neuron. 2010;68:401–8. DOI:

43. Spitznagel MB, Tremont G. Cognitive reserve and anosognosia in questionable and mild dementia. Arch Clin Neuropsychol. 2005;20:505–15. DOI :

For citation:

Damulin I.V., Ekusheva E.V. Poststroke neuroplasticity processes. Neurology, Neuropsychiatry, Psychosomatics. 2014;6(3):69-74. (In Russ.)

Views: 969

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)