Neurochemical changes underpinning the development of adjunct therapies in recovery after stroke: A role for GABA?

Author:

Johnstone Ainslie12,Levenstein Jacob M123,Hinson Emily L12,Stagg Charlotte J12ORCID

Affiliation:

1. Nuffield Department of Clinical Neurosciences, Oxford Centre for FMRI of the Brain (FMRIB), Wellcome Centre for Integrative Neuroimaging (WIN), University of Oxford, Oxford, UK

2. Department of Psychiatry, Oxford Centre for Human Brain Activity (OHBA), Wellcome Centre for Integrative Neuroimaging (WIN), University of Oxford, Oxford, UK

3. Section on Functional Imaging Methods, Laboratory of Brain and Cognition, National Institutes of Mental Health, Bethesda, MD, USA

Abstract

Stroke is a leading cause of long-term disability, with around three-quarters of stroke survivors experiencing motor problems. Intensive physiotherapy is currently the most effective treatment for post-stroke motor deficits, but much recent research has been targeted at increasing the effects of the intervention by pairing it with a wide variety of adjunct therapies, all of which aim to increase cortical plasticity, and thereby hope to maximize functional outcome. Here, we review the literature describing neurochemical changes underlying plasticity induction following stroke. We discuss methods of assessing neurochemicals in humans, and how these measurements change post-stroke. Motor learning in healthy individuals has been suggested as a model for stroke plasticity, and we discuss the support for this model, and what evidence it provides for neurochemical changes. One converging hypothesis from animal, healthy and stroke studies is the importance of the regulation of the inhibitory neurotransmitter GABA for the induction of cortical plasticity. We discuss the evidence supporting this hypothesis, before finally summarizing the literature surrounding the use of adjunct therapies such as non-invasive brain stimulation and SSRIs in post-stroke motor recovery, both of which have been show to influence the GABAergic system.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Neurology (clinical),Neurology

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