Promoting axonal rewiring to improve outcome after stroke.
A limited amount of functional recovery commonly occurs in the weeks and months after stroke, and a number of studies show that such recovery is associated with changes in the brain's functional organization. Measures that augment this reorganization in a safe and effective way may therefore help improve outcome in stroke patients. Here we review some of the evidence for functional and anatomical reorganization under normal physiological conditions, along with strategies that augment these processes and improve outcome after brain injury in animal models. These strategies include counteracting inhibitors of axon growth associated with myelin, activating neurons' intrinsic growth state, enhancing physiological activity, and having behavioral therapy. These approaches represent a marked departure from the recent focus on neuroprotection and may provide a more effective way to improve outcome after stroke.
Benowitz
Larry I
LI
Laboratories for Neuroscience Research in Neurosurgery and F.M. Kirby Neurobiology Program, Children's Hospital, USA. larry.benowitz@childrens.harvard.edu
Carmichael
S Thomas
ST
D000818:Animals; D001521:Behavior Therapy / Q000379:methods / Q000592:standards; D001921:Brain / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D004195:Disease Models, Animal; D020439:Growth Cones / Q000187:drug effects* / Q000502:physiology; D006131:Growth Inhibitors / Q000037:antagonists & inhibitors; D006801:Humans; D007288:Inosine / Q000494:pharmacology / Q000627:therapeutic use; D009414:Nerve Growth Factors / Q000494:pharmacology / Q000627:therapeutic use; D009473:Neuronal Plasticity / Q000187:drug effects* / Q000502:physiology; D020127:Recovery of Function / Q000187:drug effects* / Q000502:physiology; D020521:Stroke / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*
D006131:Growth Inhibitors; D009414:Nerve Growth Factors; D007288:Inosine