Perinatal Stroke: Mapping and Modulating Developmental Plasticity

Overview

Journal Nat Rev Neurol

Specialty Neurology

Date 2021 Jun 15

PMID 34127850

Citations 19

Authors

Adam Kirton

Megan J Metzler

Brandon T Craig

Alicia Hilderley

Mary Dunbar

Adrianna Giuffre

James Wrightson

Ephrem Zewdie

Helen L Carlson

Affiliations

Soon will be listed here.

Abstract

Most cases of hemiparetic cerebral palsy are caused by perinatal stroke, resulting in lifelong disability for millions of people. However, our understanding of how the motor system develops following such early unilateral brain injury is increasing. Tools such as neuroimaging and brain stimulation are generating informed maps of the unique motor networks that emerge following perinatal stroke. As a focal injury of defined timing in an otherwise healthy brain, perinatal stroke represents an ideal human model of developmental plasticity. Here, we provide an introduction to perinatal stroke epidemiology and outcomes, before reviewing models of developmental plasticity after perinatal stroke. We then examine existing therapeutic approaches, including constraint, bimanual and other occupational therapies, and their potential synergy with non-invasive neurostimulation. We end by discussing the promise of exciting new therapies, including novel neurostimulation, brain-computer interfaces and robotics, all focused on improving outcomes after perinatal stroke.

Citing Articles

Causation, trait correlation, and translation: Developmental brain imaging in research on neuropsychiatric conditions of childhood.

Constantino J, Constantino-Pettit A Dev Cogn Neurosci. 2025; 72:101513.

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Neuromodulation for Children With Hemiparesis and Perinatal Stroke: A Randomized Clinical Trial.

Hilderley A, Dunbar M, Andersen J, Fehlings D, Metzler M, Carlson H JAMA Neurol. 2025; 82(3):267-275.

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Experience-driven competition in neural reorganization after stroke.

Jones T, Nemchek V, Fracassi M J Physiol. 2024; 603(3):737-757.

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Presumed Perinatal Ischemic Left Middle Cerebral Artery Stroke With Cerebral Palsy, Developmental Delay, and Epilepsy: A Case Report.

Randhawa H, Randhawa J, Aulakh K, More A, Jain A Cureus. 2024; 16(8):e66337.

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Perinatal arterial ischemic stroke diagnosed in infants receiving therapeutic hypothermia for hypoxic-ischemic encephalopathy.

Gonzalez F, Monsell S, Cornet M, Glass H, Wisnowski J, Mathur A Pediatr Res. 2024; .

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