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Corticospinal tract: a new hope for the treatment of post-stroke spasticity

Linxing Huang, Lizhen Yi, Huiyuan Huang, Sheng Zhan, Ruixue Chen, Zenghui Yue

2023Acta Neurologica Belgica17 citationsDOIOpen Access PDF

Abstract

Stroke is the third leading cause of death and disability worldwide. Post-stroke spasticity (PSS) is the most common complication of stroke but represents only one of the many manifestations of upper motor neuron syndrome. As an upper motor neuron, the corticospinal tract (CST) is the only direct descending motor pathway that innervates the spinal motor neurons and is closely related to the recovery of limb function in patients with PSS. Therefore, promoting axonal remodeling in the CST may help identify new therapeutic strategies for PSS. In this review, we outline the pathological mechanisms of PSS, specifically their relationship with CST, and therapeutic strategies for axonal regeneration of the CST after stroke. We found it to be closely associated with astroglial scarring produced by astrocyte activation and its secretion of neurotrophic factors, mainly after the onset of cerebral ischemia. We hope that this review offers insight into the relationship between CST and PSS and provides a basis for further studies.

Topics & Concepts

Corticospinal tractMedicineSpasticityStroke (engine)NeuroscienceNeurologyNeurotrophic factorsUpper motor neuronPhysical medicine and rehabilitationMotor neuronPyramidal tractsAmyotrophic lateral sclerosisPsychologyPathologyInternal medicineDiseaseMagnetic resonance imagingAnatomyDiffusion MRIEngineeringReceptorMechanical engineeringRadiologyNerve injury and regenerationBotulinum Toxin and Related Neurological DisordersCerebral Palsy and Movement Disorders
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