Premium
Ipsilateral motor pathways to the lower limb after stroke: Insights and opportunities
Author(s) -
Cleland Brice T.,
Madhavan Sangeetha
Publication year - 2021
Publication title -
journal of neuroscience research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.72
H-Index - 160
eISSN - 1097-4547
pISSN - 0360-4012
DOI - 10.1002/jnr.24822
Subject(s) - corticospinal tract , physical medicine and rehabilitation , stroke (engine) , neuroscience , psychology , upper limb , motor system , pyramidal tracts , rehabilitation , perspective (graphical) , medicine , magnetic resonance imaging , diffusion mri , computer science , mechanical engineering , engineering , radiology , artificial intelligence
Abstract Stroke‐related damage to the crossed lateral corticospinal tract causes motor deficits in the contralateral (paretic) limb. To restore functional movement in the paretic limb, the nervous system may increase its reliance on ipsilaterally descending motor pathways, including the uncrossed lateral corticospinal tract, the reticulospinal tract, the rubrospinal tract, and the vestibulospinal tract. Our knowledge about the role of these pathways for upper limb motor recovery is incomplete, and even less is known about the role of these pathways for lower limb motor recovery. Understanding the role of ipsilateral motor pathways to paretic lower limb movement and recovery after stroke may help improve our rehabilitative efforts and provide alternate solutions to address stroke‐related impairments. These advances are important because walking and mobility impairments are major contributors to long‐term disability after stroke, and improving walking is a high priority for individuals with stroke. This perspective highlights evidence regarding the contributions of ipsilateral motor pathways from the contralesional hemisphere and spinal interneuronal pathways for paretic lower limb movement and recovery. This perspective also identifies opportunities for future research to expand our knowledge about ipsilateral motor pathways and provides insights into how this information may be used to guide rehabilitation.