The interaction between training and plasticity in the poststroke brain

TLDR: This work addresses both the biology of the brain's postischemic sensitive period and the difficult question of what kind of training best exploits this period, and finds ways to augment and prolong the sensitive period using pharmacological agents or noninvasive brain stimulation.

Abstract: Purpose of review Recovery after stroke can occur either via reductions in impairment or through compensation. Studies in humans and non-human animal models show that most recovery from impairment occurs in the first 1 to 3 months after stroke as a result of both spontaneous reorganization and increased responsiveness to enriched environments and training. Improvement from impairment is attributable to a short-lived sensitive period of post-ischemic plasticity defined by unique genetic, molecular, physiological and structural events. In contrast, compensation can occur at any time after stroke. Here we address both the biology of the brain's post-ischemic sensitive period and the difficult question of what kind of training (task-specific vs. a stimulating environment for self-initiated exploration of various natural behaviors) best exploits this period.