Conectividade das redes neurais após Acidente Vascular Encefálico (AVC) e na recuperação dos déficits sensoriomotores: revisão de literatura

Abstract

INTRODUCTION. An important challenge is to identify the neural mechanisms involved with deficits and sensory and motor rehabilitation after stroke. We hope that by exploring the connectivity of the neural network it helps to understand the effects of the stroke on brain function. We hypothesize that the damage caused by the stroke on brain function and sensorymotor deficits are related to the interruption or pathological changes of neural network connections and abnormal neuronal activity. OBJECTIVE: To identify and review the literature studies that used noninvasive methods of analysis to describe the effects of the stroke on the connectivity of neural networks in sensorymotor regions and during sensorymotor recovery / rehabilitation. METHODOLOGY: Electronic search for literary references in the period from 2010 to 2015 and manual selection of texts. RESULTS. With the methodology employed, we obtained a total of 26 studies included. DISCUSSION. Neural activity in the ipsilesional sensorimotor cortex is observed in the early and late stages of the stroke. The persistence of the excess of the activity of the contralesional hemisphere in the chronic phase is associated with poor sensorymotor recovery. Changes in functional connectivity during motor recovery did not involve all brain regions to the same extent. The data demonstrate a strong association between corticospinal tract damage and stroke impairment, but there is a complex link between neural communication and neuroanatomic connectivity. More severely compromised patients have: decreased interaction of the corticocorticals motor regions of the ipsilateral hemisphere and increased interaction of corticospinal motor regions of the contralesional hemisphere, abolition of functional connectivity of the cortical areas to the cerebellum; and severe damage to the corticospinal tract. The most relevant finding in changes in effective connectivity is the reduction of intrahemispheric interactions. Intervention studies have identified that there is a relationship in the connectivity changes after establishing different procedures. CONCLUSION: Caution is required in interpreting the results. This review attempts to point out the current pathways of neuroscience by investigating the relationship between stroke and neural network connectivity. Other investigations are suggested, because at the moment, there is a cessation of new and important findings.