Neural mechanisms of interleaved practice that support long-term retention of motor skill in stroke: translational research perspective

摘要

A fifteen million people suffer stroke worldwide each year according to the World Health Organization. Stroke is the leading cause of long-term disability with motor deficit being the most common deficit after stroke (World Health Organization, 2002). Because neural plasticity is believed to be central to the acquisition of motor skill and learning in the intact brain as well as relearning in the damaged brain, recent advances in understanding, experience-dependent neural plasticity can inform ongoing development and adaptation of contemporary therapeutic interventions to improve recovery and rehabilitation (Dimyan and Cohen, 2011; Winstein and Kay, 2015). Unfortunately, identification of theory-driven best-practice has been hampered because many clinical trials are implemented during the chronic rather than acute stage after stroke, a period during which plastic changes supporting recovery are less likely to emerge. These trials are further hindered by despite the use of novel technologies, such as robotic-guided training, being used either in isolation or as an adjunct to contemporary behavioral intervention, to induce greater dosing (Krakauer, 2006).