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Functional neuroimaging in stroke recovery and neurorehabilitation: conceptual issues and perspectives

Authors

  • Leeanne M. Carey,

    Corresponding author
    1. National Stroke Research Institute, Neurosciences Building, Heidelberg Heights, Vic., Australia
    2. School of Occupational Therapy, LaTrobe University, Bundoora, Vic., Australia
      Prof. Leeanne M. Carey*, National Stroke Research Institute, Neurosciences Building, 300 Waterdale Road, Heidelberg Heights, Vic. 3081, Australia. Tel: +61 3 9496 2586, Fax:+61 3 9496 2650; e-mail: lcarey@nsri.org.au.
      Prof Rüdiger J. Seitz email: seitzr@uni-duesseldorf.de
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  • Rüdiger J. Seitz

    1. National Stroke Research Institute, Neurosciences Building, Heidelberg Heights, Vic., Australia
    2. Institute of Advanced Study, La Trobe University, Bundoora, Vic., Australia
    3. Department of Neurology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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Prof. Leeanne M. Carey*, National Stroke Research Institute, Neurosciences Building, 300 Waterdale Road, Heidelberg Heights, Vic. 3081, Australia. Tel: +61 3 9496 2586, Fax:+61 3 9496 2650; e-mail: lcarey@nsri.org.au.
Prof Rüdiger J. Seitz email: seitzr@uni-duesseldorf.de

Abstract

Background In stroke, functional neuroimaging has become a potent diagnostic tool; opened new insights into the pathophysiology of ischaemic damage in the human brain; and made possible the assessment of functional–structural relationships in postlesion recovery.

Summary of review Here, we give a critical account on the potential and limitation of functional neuroimaging and discuss concepts related to the use of neuroimaging for exploring the neurobiological and neuroanatomical mechanisms of poststroke recovery and neurorehabilitation.

We identify and provide evidence for five hypotheses that functional neuroimaging can provide new insights into:

  • 1adaptation occurs at the level of functional brain systems;
  • 2the brain–behaviour relationship varies with recovery and over time;
  • 3functional neuroimaging can improve our ability to predict recovery and select individuals for rehabilitation;
  • 4mechanisms of recovery reflect different pathophysiological phases; and
  • 5brain adaptation may be modulated by experience and specific rehabilitation.

The significance and application of this new evidence is discussed, and recommendations made for investigations in the field.

Conclusion Functional neuroimaging is an important tool to explore the mechanisms underlying brain plasticity and, thereby, to guide clinical research in neurorehabilitation.

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