Mechanisms of functional recovery after stroke

Stroke is a leading cause of disability. After initial stabilization, neurologic recovery takes place even in the acute phase. Well-known recovery mechanisms from stroke deficits are improvement from diaschisis, or functional reorganization of the ipsilesional or contralesional cortex with involvement of uncrossed corticospinal tract fibers. The importance of coactivation of the perilesional or contralesional cortex is unknown; however, neuronal plasticity plays an important role in neurologic recovery. With the recent advancements in knowledge regarding underlying mechanisms of neuronal plasticity, various functional modulating methods have been developed and studied in humans. In this review, basic mechanisms of functional recovery and potential targets for future research will be discussed.