Improving Disability in Stroke though Gating and Homeostatic Metaplasticity

摘要

Motor relearning after stroke depends on reorganisation and synaptic plasticity in the motor cortex of the lesioned hemisphere. Recent evidence showed that the extent of practice-dependent plasticity in healthy subjects and in stroke patients can be purposefully enhanced by experimental manipulation. One fundamental principle of improving motor learning is to increase the excitability of the practicing motor cortex by disinhibition transcranial brain stimulation concurrently with motor practice. This principle is being referred to as gating. Another fundamental principle of improving motor learning is to decrease the threshold for induction of synaptic plasticity by a period of low neuronal network activity prior to motor practice. This is being referred to as homeostatic metaplasticity. This presentation will give examples for gating and homeostatic metaplasticity in order to enhance motor learning in healthy subjects and patients after stroke.