ArticleFrontiers in neurology2019
A Unifying Pathophysiological Account for Post-stroke Spasticity and Disordered Motor Control.
Article in Frontiers in neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 95 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
95 citing papers in PubMed, 2 syntheses or guidelines pooled it, 146 citations in OpenAlex.
- The Effectiveness of Massage Therapy for Improving Sequelae in Post-Stroke Survivors. A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2021Pooled it
- Effect of Acupuncture on Neuroplasticity of Stroke Patients with Motor Dysfunction: A Meta-Analysis of fMRI Studies.Neural plasticity · 2021Pooled it
- Effects of unsupervised walking on walk performance and functional mobility in individuals with chronic stroke: a blind randomized clinical trial.Sao Paulo medical journal = Revista paulista de medicina · 2025Trial
- Cerebellar Intermittent Theta-Burst Stimulation Reduces Upper Limb Spasticity After Subacute Stroke: A Randomized Controlled Trial.Frontiers in neural circuits · 2021Trial
- Trial
- Article
- Online modulation of neural drive to lower motor neurons with high-definition transcranial alternating current stimulation (HD-tACS).Journal of neuroengineering and rehabilitation · 2026Article
- Beyond spasticity reduction: botulinum toxin-a injection is associated with changes in abnormal flexor synergies of the upper limb in chronic stroke.Journal of rehabilitation medicine · 2026Article
- A Spinal Origin for the Obligate Flexor Synergy in the Nonhuman Primate: Implications for Control of Reaching.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2026Article
- Stretching-Positioned Extracorporeal Shock Wave Therapy Yields Superior Short-Term Efficacy for Post-Stroke Upper-Limb Spasticity: A Retrospective Comparative Study.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- Automated Quantification of Movement Qualities in the Human Upper Extremity After Stroke Using a Wearable Robot.Research square · 2026Article
- Self-Organizing Recruitment of Compensatory Cortical Areas Post-Stroke Can Maximize Residual Motor Performance.IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society · 2026Article
- Restoration of temporal separability between beta and movement ensemble co-firing with motor recovery.Neuron · 2025Article
- Quantitative assessment of dynamic movement reveals deficits due to hemiparetic stroke.Journal of neuroengineering and rehabilitation · 2025Article
- Neuroengineering approaches assessing structural and functional changes of motor descending pathways in stroke.Progress in biomedical engineering (Bristol, England) · 2025Review
- The Future of Chemogenetics for the Treatment of Spasticity.Molecular diagnosis & therapy · 2025Review
- Pathophysiology of voluntary motor commands at the level of the spinal motoneuron in patients with multiple sclerosis.medRxiv : the preprint server for health sciences · 2025Article
- A spinal origin for the obligate flexor synergy in the non-human primate: Implications for control of reaching.bioRxiv : the preprint server for biology · 2025Article
- The Role of Hemispheric Sensory Shifts: Impacts on Stretch Reflex and Motor Plasticity Post-Stroke.Medical hypotheses · 2025Article
- Reevaluating fibromyalgia diagnosis: a proposal to integrate deep tendon reflex responses into current criteria.Rheumatology international · 2025Review
35 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
Cortical and subcortical plastic reorganization occurs in the course of motor recovery after stroke. It is largely accepted that plasticity of ipsilesional motor cortex primarily contributes to recovery of motor function, while the contributions of contralesional motor cortex are not completely understood. As a result of damages to motor cortex and its descending pathways and subsequent unmasking of inhibition, there is evidence of upregulation of reticulospinal tract (RST) excitability in the contralesional side. Both animal studies and human studies with stroke survivors suggest and support the role of RST hyperexcitability in post-stroke spasticity. Findings from animal studies demonstrate the compensatory role of RST hyperexcitability in recovery of motor function. In contrast, RST hyperexcitability appears to be related more to abnormal motor synergy and disordered motor control in stroke survivors. It does not contribute to recovery of normal motor function. Recent animal studies highlight laterality dominance of corticoreticular projections. In particular, there exists upregulation of ipsilateral corticoreticular projections from contralesional premotor cortex (PM) and supplementary motor area (SMA) to medial reticular nuclei. We revisit and revise the previous theoretical framework and propose a unifying account. This account highlights the importance of ipsilateral PM/SMA-cortico-reticulospinal tract hyperexcitability from the contralesional motor cortex as a result of disinhibition after stroke. This account provides a pathophysiological basis for post-stroke spasticity and related movement impairments, such as abnormal motor synergy and disordered motor control. However, further research is needed to examine this pathway in stroke survivors to better understand its potential roles, especially in muscle strength and motor recovery. This account could provide a pathophysiological target for developing neuromodulatory interventions to manage spasticity and thus possibly to facilitate motor recovery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.