Plasticity of motor cortex excitability induced by rehabilitation therapy for writing

The mechanisms of rehabilitation-induced plasticity in the motor system after stroke are not defined. The authors studied seven patients with residual poststroke agraphia, aphasia, and right hemiparesis. After a 40-minute rehabilitation therapy that promoted use of the paretic hand for writing, the authors observed a task-specific increase in recruitment of ipsilateral corticospinal pathways. Rehabilitation aimed to increase the use of the paretic hand may induce recruitment of previously silent ipsilateral corticospinal pathways even in poorly recovered poststroke patients.