Abstract
Introduction: The onset of perinatal stroke often goes unnoticed, and it is only recognized several months or even years later, typically as hemiparetic cerebral palsy. This delay makes it nearly impossible to conduct longitudinal studies from the time of injury, hindering the understanding of the underlying pathophysiological mechanisms and limiting the development of targeted therapeutic strategies.
Contents: This analysis supports the conceptual hypothesis that a reduction in cortical inhibition after perinatal stroke contributes to recovery and further suggests that this reduction may be induced by deafferentation. As muscle activity begins to recover, the degree of deafferentation also changes, leading to a dynamic and sequential modulation of cortical inhibition. This evolving inhibitory state influences the way in which the motor system reorganizes, ultimately shaping the three corticospinal patterns observed in patients with perinatal stroke. Based on this model, transcranial stimulation is discussed as a potential avenue for future research, given its capacity to reduce cortical inhibition.
Conclusion: It is proposed that recovery from perinatal stroke follows a dynamic and sequential process, which is represented by three corticospinal patterns. This conceptual framework opens up new avenues for future research, including the potential for personalized therapeutic strategies involving transcranial stimulation, tailored to each patient’s unique corticospinal organization.
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