title: [Enhancement of motor relearning and functional recovery in stroke patients: non-invasive strategies for modulating the central nervous system].
abstract: BACKGROUND
  Most of the stroke survivors do not recover the basal state of the affected upper limb, suffering from a severe disability which remains during the chronic phase of the illness. This has an extremely negative impact in the quality of life of these patients. Hence, neurorehabilitation strategies aim at the minimization of the sensorimotor dysfunctions associated to stroke, by promoting neuroplasticity in the central nervous system.
  
  
  METHODS
  Brain reorganization can facilitate motor and functional recovery in stroke subjects. None-theless, after the insult, maladaptive neuroplastic changes can also happen, which may lead to the appearance of certain sensori-motor disorders such as spasticity. Noninvasive brain stimulation strategies, like transcranial direct current stimulation or transcranial magnetic stimulation, are widely used techniques that, when applied over the primary motor cortex, can modify neural networks excitability, as well as cognitive functions, both in healthy subjects and individuals with neurological disorders. Similarly, brain-machine-interface systems also have the potential to induce a brain reorganization by the contingent and simultaneous association between the brain activation and the peripheral stimulation.
  
  
  CONCLUSIONS
  This review describes the positive effects of the previously mentioned neurorehabilitation strategies for the enhancement of cortical reorganization after stroke, and how they can be used to alleviate the symptoms of the spasticity syndrome.
authors.affiliation: Hospital Nacional de Paraplejicos, 45071 Toledo, Espana.|Universidad de San Jorge, Zaragoza, Espana.|Grupo de Investigacion en Fisioterapia de Toledo (GIFTO), Toledo, Espana.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bravo-Esteban
authors.affiliation: Universidad de Zaragoza, Zaragoza, Espana.|Instituto de Investigacion en Ingenieria de Aragon, Zaragoza, Espana.
authors.forename: Eduardo
authors.initials: E
authors.lastname: López-Larraz
mesh_terms: D002490:Central Nervous System / Q000503:physiopathology; D006801:Humans; D009048:Motor Skills; D009473:Neuronal Plasticity; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation / Q000379:methods*; D065908:Transcranial Direct Current Stimulation / Q000379:methods; D050781:Transcranial Magnetic Stimulation / Q000379:methods