Physiological basis of neuromotor recovery

Planning and execution of movement require coordinated activity from several interconnected cortical motor areas. When an area in this specialized motor network is damaged (e.g., through traumatic brain injury or ischemic event), motor network activity can be disrupted, leading to functional deficits. How the surviving motor network reorganizes to compensate for the injury and functional deficits can vary as a pathological consequence of the location and extent of the brain injury. The current chapter summarizes how neuroplasticity modifies motor networks in response to injury by focusing on the changes after an ischemic event in the primary motor cortex. Neuroanatomical and neurophysiological evidence in animal models and human stroke survivors is reviewed to demonstrate how injuries functionally impair motor networks, how motor networks compensate for injury to improve motor function, and how select therapies help facilitate recovery. Further research into these neuroplasticity mechanisms may one day help to develop more effective rehabilitation strategies.