Rethinking Remapping: Circuit Mechanisms of Recovery after Stroke

Stroke is one of the most common causes of disability, and there are few treatments that can improve recovery after stroke. Therapeutic development has been hindered because of a lack of understanding of precisely how neural circuits are affected by stroke, and how these circuits change to mediate r...

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Bibliographic Details
Published in:The Journal of neuroscience 2023-11, Vol.43 (45), p.7489-7500
Main Authors: Campos, Baruc, Choi, Hoseok, DeMarco, Andrew T, Seydell-Greenwald, Anna, Hussain, Sara J, Joy, Mary T, Turkeltaub, Peter E, Zeiger, William
Format: Article
Language:English
Subjects:
Animal models
Animals
Cerebral Cortex
Cerebral hemispheres
Circuits
Cortex (temporal)
Functional morphology
Humans
Hypotheses
Interrogation
Neural networks
Neurons
Population dynamics
Pyramidal Tracts
Recovery
Recovery of function
Recovery of Function - physiology
Redundancy
Spatial discrimination
Spatial resolution
Stroke
Structure-function relationships
Symposium and Mini-Symposium
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Summary:Stroke is one of the most common causes of disability, and there are few treatments that can improve recovery after stroke. Therapeutic development has been hindered because of a lack of understanding of precisely how neural circuits are affected by stroke, and how these circuits change to mediate recovery. Indeed, some of the hypotheses for how the CNS changes to mediate recovery, including remapping, redundancy, and diaschisis, date to more than a century ago. Recent technological advances have enabled the interrogation of neural circuits with ever greater temporal and spatial resolution. These techniques are increasingly being applied across animal models of stroke and to human stroke survivors, and are shedding light on the molecular, structural, and functional changes that neural circuits undergo after stroke. Here we review these studies and highlight important mechanisms that underlie impairment and recovery after stroke. We begin by summarizing knowledge about changes in neural activity that occur in the peri-infarct cortex, specifically considering evidence for the functional remapping hypothesis of recovery. Next, we describe the importance of neural population dynamics, disruptions in these dynamics after stroke, and how allocation of neurons into spared circuits can restore functionality. On a more global scale, we then discuss how effects on long-range pathways, including interhemispheric interactions and corticospinal tract transmission, contribute to post-stroke impairments. Finally, we look forward and consider how a deeper understanding of neural circuit mechanisms of recovery may lead to novel treatments to reduce disability and improve recovery after stroke.
ISSN:0270-6474
1529-2401
DOI:10.1523/JNEUROSCI.1425-23.2023