Adaptive plasticity in motor cortex: implications for rehabilitation after brain injury.

It is now widely recognized that the cerebral cortex of adult human and non-human mammals is capable of widespread functional and structural plasticity. During the learning of new skills, cortical regions associated with sensorimotor function of the body parts most utilized for the skilled task come to be represented over larger cortical territories. More recent studies have shown that functional and structural changes take place in the cerebral cortex after injury, such as occurs after stroke or trauma. These two modulators of cortical function, sensorimotor learning and cortical injury, interact. Thus, after cortical injury, the structure and function of undamaged parts of the brain are remodeled during recovery, shaped by the sensorimotor experiences of the individual in the weeks to months following injury. These recent neuroscientific findings suggest that new rehabilitative interventions, both physiotherapeutic and pharmacotherapeutic, may have benefit via modulation of neuroplastic mechanisms.