A neuroanatomical framework for upper limb synergies after stroke

Frontiers in Human Neuroscience
Angus J C McMorlandWinston D Byblow

Abstract

Muscle synergies describe common patterns of co- or reciprocal activation that occur during movement. After stroke, these synergies change, often in stereotypical ways. The mechanism underlying this change reflects damage to key motor pathways as a result of the stroke lesion, and the subsequent reorganization along the neuroaxis, which may be further detrimental or restorative to motor function. The time course of abnormal synergy formation seems to lag spontaneous recovery that occurs in the initial weeks after stroke. In healthy individuals, motor cortical activity, descending via the corticospinal tract (CST) is the predominant driver of voluntary behavior. When the CST is damaged after stroke, other descending pathways may be up-regulated to compensate. The contribution of these pathways may emerge as new synergies take shape at the chronic stage after stroke, as a result of plasticity along the neuroaxis. The location of the stroke lesion and properties of the secondary descending pathways and their regulation are then critical for shaping the synergies in the remaining motor behavior. A consideration of the integrity of remaining descending motor pathways may aid in the design of new rehabilitation therapies.

Associated Clinical Trials

Nov 6, 2019·Cheung Chi Kwan Vincent

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Citations

Apr 20, 2017·Frontiers in Neurology·Sheng Li
Feb 20, 2018·The Journal of Physiology·Jacob G McPhersonJulius P A Dewald
Feb 6, 2018·Reviews in the Neurosciences·Sharon IsraelyEli Carmeli
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Aug 17, 2019·Neurorehabilitation and Neural Repair·Merav R Senesh, David J Reinkensmeyer
Oct 31, 2017·Frontiers in Bioengineering and Biotechnology·Alessandro ScanoFranco Molteni
Aug 28, 2020·Neurorehabilitation and Neural Repair·Firas MawasePablo Celnik
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Jun 24, 2017·Disability and Rehabilitation·Nyeonju Kang, James H Cauraugh
Apr 25, 2018·Frontiers in Human Neuroscience·Jacob G McPhersonJulius P A Dewald
Jun 9, 2018·Scientific Reports·Gustavo BalbinotDale Corbett
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Jul 7, 2018·Frontiers in Human Neuroscience·Pablo A Ortega-AuriolAngus J C McMorland
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Sep 3, 2021·Journal of Rehabilitation and Assistive Technologies Engineering·Shenan Hoppe-LudwigArun Jayaraman
Nov 20, 2021·Neurorehabilitation and Neural Repair·Gustavo BalbinotDiane C Lagace

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