New insights into the pathophysiology of post-stroke spasticity
Spasticity is one of many consequences after stroke. It is characterized by a velocity-dependent increase in resistance during passive stretch, resulting from hyperexcitability of the stretch reflex. The underlying mechanism of the hyperexcitable stretch reflex, however, remains poorly understood. A...
| Main Authors: | , |
|---|---|
| Format: | Online |
| Language: | English |
| Published: |
Frontiers Media S.A.
2015
|
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392691/ |
| id |
pubmed-4392691 |
|---|---|
| recordtype |
oai_dc |
| spelling |
pubmed-43926912015-04-24 New insights into the pathophysiology of post-stroke spasticity Li, Sheng Francisco, Gerard E. Neuroscience Spasticity is one of many consequences after stroke. It is characterized by a velocity-dependent increase in resistance during passive stretch, resulting from hyperexcitability of the stretch reflex. The underlying mechanism of the hyperexcitable stretch reflex, however, remains poorly understood. Accumulated experimental evidence has supported supraspinal origins of spasticity, likely from an imbalance between descending inhibitory and facilitatory regulation of spinal stretch reflexes secondary to cortical disinhibition after stroke. The excitability of reticulospinal (RST) and vestibulospinal tracts (VSTs) has been assessed in stroke survivors with spasticity using non-invasive indirect measures. There are strong experimental findings that support the RST hyperexcitability as a prominent underlying mechanism of post-stroke spasticity. This mechanism can at least partly account for clinical features associated with spasticity and provide insightful guidance for clinical assessment and management of spasticity. However, the possible role of VST hyperexcitability cannot be ruled out from indirect measures. In vivo measure of individual brainstem nuclei in stroke survivors with spasticity using advanced fMRI techniques in the future is probably able to provide direct evidence of pathogenesis of post-stroke spasticity. Frontiers Media S.A. 2015-04-10 /pmc/articles/PMC4392691/ /pubmed/25914638 http://dx.doi.org/10.3389/fnhum.2015.00192 Text en Copyright © 2015 Li and Francisco. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Li, Sheng Francisco, Gerard E. |
| spellingShingle |
Li, Sheng Francisco, Gerard E. New insights into the pathophysiology of post-stroke spasticity |
| author_facet |
Li, Sheng Francisco, Gerard E. |
| author_sort |
Li, Sheng |
| title |
New insights into the pathophysiology of post-stroke spasticity |
| title_short |
New insights into the pathophysiology of post-stroke spasticity |
| title_full |
New insights into the pathophysiology of post-stroke spasticity |
| title_fullStr |
New insights into the pathophysiology of post-stroke spasticity |
| title_full_unstemmed |
New insights into the pathophysiology of post-stroke spasticity |
| title_sort |
new insights into the pathophysiology of post-stroke spasticity |
| description |
Spasticity is one of many consequences after stroke. It is characterized by a velocity-dependent increase in resistance during passive stretch, resulting from hyperexcitability of the stretch reflex. The underlying mechanism of the hyperexcitable stretch reflex, however, remains poorly understood. Accumulated experimental evidence has supported supraspinal origins of spasticity, likely from an imbalance between descending inhibitory and facilitatory regulation of spinal stretch reflexes secondary to cortical disinhibition after stroke. The excitability of reticulospinal (RST) and vestibulospinal tracts (VSTs) has been assessed in stroke survivors with spasticity using non-invasive indirect measures. There are strong experimental findings that support the RST hyperexcitability as a prominent underlying mechanism of post-stroke spasticity. This mechanism can at least partly account for clinical features associated with spasticity and provide insightful guidance for clinical assessment and management of spasticity. However, the possible role of VST hyperexcitability cannot be ruled out from indirect measures. In vivo measure of individual brainstem nuclei in stroke survivors with spasticity using advanced fMRI techniques in the future is probably able to provide direct evidence of pathogenesis of post-stroke spasticity. |
| publisher |
Frontiers Media S.A. |
| publishDate |
2015 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392691/ |
| _version_ |
1613210149918343168 |