What is the evidence for use dependent learning after stroke? Stroke 40(3 Suppl

Our laboratory has been interested in the patterns ofsynaptic plasticity after cortical stroke in animal mod-els.1 These protein expression studies suggest that regions both ipsilateral and contralateral to the stroke are involved during the recovery period. An emerging issue of interest is whether the recovered function is indeed normal or reflects some compensatory function.2 One approach to resolving these questions is to assess different patterns of functional recovery in patients who do and do not recover function with and without therapy and compare them to normal patterns. Investigation of the molecular mechanisms of brain plasticity after injury suggests that functional activity stimulates this recovery and guides the development of functional path-ways.3,4 Several investigators postulate that recovery from stroke resembles “use-dependent ” learning.5 For this report, we review pertinent literature related to this phenomenon