Study of Ability of Plastic Motor of Cerebral Cortex in Patients after Stroke (Literature Review)

Cerebral stroke remains one of the leading causes of death and disability in patients, leaving in some cases significant neurological deficit. Motor activity is controlled by a motor system, which consists of a number of cortical and subcortical areas interacting through a system of anatomical, functional, effective and network connectivity. Damage to any of these areas or systems of connectivity entails a violation of the motor function. There is some evidence pointing to reappraisal motor networks, including the reorganization of brain areas and different types of connectivity that promotes the recovery of motor functions. The neurophysiological mechanisms that allow recovering the motor functions of stroke patients are various. In the early period (first days and weeks after stroke), the importance represents the recovery of the functional activity of morphologically intact but temporarily disorganized neurons located perifocal in relation to the lesion. This is possible due to the resolution of edema, developing in the first weeks after stroke, and development of collateral circulation and restore perfusion of the affected brain areas. Further neurophysiological basis of recovery became the processes of brain plasticity related to reorganization of normal physiological connectivity between various brain structures involved in the implementation of motor function. Plastic changes can take place at all levels of the CNS, however, most often, based plasticity is the reprogramming or modification of the architecture of neural networks. The phenomenon of plasticity was in various brain regions, including the cortex and subcortical structures. This article presents the results of recent studies which describe models of anatomical, functional, effective connectivity, and examine influences of ischemia on motor function and functional recovery. It is assumed that the changing relations constitute an important pathophysiological aspect of influence, on the one hand on the volume of motor deficits in post-stroke patients, on the other hand is an extremely important mechanism involved in the recovery of lost motor functions. Study of structural and functional changes after stroke using neuroimaging techniques such as magnetic resonance imaging (MRI), has made a significant contribution to our understanding of the mechanisms of recovery of motor activity after ischemic brain damage. Application of these methods can provide a deeper understanding of the processes of dysfunction and functional reorganization as a result of activation of certain areas of the brain that can be the subject of study with the goal of predicting outcomes and the development of new therapeutic direction.