Post‑stroke Spasticity as a Manifestation of Maladaptive Plasticity and its Modulation by Botulinum Toxin Treatment

Česká verzia

Authors: T. Veverka; P. Hluštík; P. Kaňovský
Authors place of work: Neurologická klinika LF UP a FN Olomouc
Published in the journal: Cesk Slov Neurol N 2014; 77/110(3): 295-301
Category: Review Article

Tato práce vznikla za grantové podpory IGA MZ ČR číslo NT13575- 4/ 2012 a MZ ČR – RVO („Fakultní nemocnice Olomouc – FNOl, IČ: 00098892“).

Summary

Stroke is the leading cause of disability worldwide. Even the adult brain is capable of structural and functional reorganization following stroke, the resulting neural plasticity is assumed to underlie most of the recovery of neurological deficit. Other neuroplastic changes, however, may worsen neurological functions. Development of post‑stroke spasticity can be considered an example of such maladaptive plasticity. It is estimated that 20– 40% of stroke survivors develop spasticity. Post‑stroke spasticity affects functional status and quality of life of patients and represents a significant socioeconomic burden. Therapy of post‑stroke spasticity requires team collaboration, treatment strategies consist of physiotherapy and botulinum toxin application. Botulinum toxin type A is currently considered first‑line therapy for post‑stroke spasticity. In addition to peripheral effects of botulinum toxin on the neuromuscular junction, there is growing evidence of distant effects on the CNS. The results of recent studies using functional magnetic resonance imaging in the chronic stroke patients suggest that botulinum toxin injected into the spastic muscle modulates the abnormal cortical reorganization (maladaptive plasticity).

Key words:
stroke – plasticity – spasticity – botulinum toxin – cortex

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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