bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2019-1-82-92bekhterev-237Research ArticleВ ПОМОЩЬ ПРАКТИКУЮЩЕМУ ВРАЧУGUIDELINES FOR THE PRACTITIONERФакторы, влияющие на эффективность постинсультной двигательной реабилитацииInfluencing the effectiveness of post-stroke motor rehabilitation factorsЗахаровД. В.ZaharovD. V.

к.м.н., заведующий отделения реабилитации психоневрологических больных

zaharov_dv@mail.ruМихайловВ. А.MihailovV. A.

д.м.н., заместитель директора по инновационному научному развитию и международному сотрудничеству, руководитель международного отдела, главный научный сотрудник и научный руководитель отделения реабилитации психоневрологических больных

vladmikh@yandex.ruФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева» МЗ РФ, Санкт-ПетербургРоссияV.M. Bekhterev National research medical center for psychiatry and neurologyRussian Federation201915052019018292Copyright © Захаров Д.В., Михайлов В.А., 20192019Захаров Д.В., Михайлов В.А.Zaharov D.V., Mihailov V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/237

Рассматриваются вопросы нейрореабилитации пациентов, перенесших инсульт. Подчеркивается значение феномена нейропластичности, лежащего в основе восстановительных процессов после поражения головного мозга. Рассматриваются принципы восстановительной терапии у перенесших инсульт больных. Особое внимание уделяется вопросу фармакотерапии, через нейротрансмитеры ориентированной на повышение нейропластичности и нейрогенеза.

The issues of neurorehabilitation of stroke patients are considered. The importance of the phenomenon of neuroplasticity, which underlies the regenerative processes after brain damage is emphasized. The principles of rehabilitation therapy in stroke patients are considered. Particular attention is paid to the issue of pharmacotherapy through neurotransmitters focused on increasing neuroplasticity and neurogenesis.

нейрореабилитацияинсультнейропластичностьneurorehabilitationstrokeneuroplasticityReferencesБалунов О.А., Михайлов В.А., Садов О.Г., Алемасова А.Ю. Эффективность глиатилина в системе реабилитационных мероприятий у постинсультных больных с мнестико-интеллектуальными нарушениями. в сб. «Сосудистая патология нервной системы».—СПб.—1998.—С.173-174.Balunov O.A., Mikhailov V.A., Sadov O.G., Alemaso- va A.Yu. The effectiveness of gliatilin in the system of rehabilitation measures in post-stroke patients with mental disorders. on Saturday «Vascular pathology of the nervous system» .— SPb.—1998.—P.173-174Балунов О.А., Черненков В.П., Михайлов В.А., Садов О.Г., Алемасова А.Ю. Исследование клинической эффективности глиатилина у больных с мультиинфарктой деменцией в сб. «Неотложная неврология» материалы научно-практической конференции.—Омск.—1998.—С.7-9.Balunov O.A., Chernenkov V.P., Mikhailov V.A., Sadov O.G., Alemasova A.Yu. A study of the clinical efficacy of gliatilin in patients with multi-infarction dementia on Saturday. “Emergency Neurology” materials of the scientific-practical conference. —Omsk—1998.— P. 7-9Барышников А.Ю., Шишкин Ю.В. Иммуно- логические проблемы апоптоза.- М.—2002.— 318с.Baryshnikov A.Yu., Shishkin Yu.V. Immunological problems of apoptosis.—M.—2002.—318cГусев Е.И., Скворцова В.И. Ишемия головного мозга.—Москва: Медицина.—2001.—328с.Gusev EI, Skvortsova VI. Ishemiyagolovnogomozga [Brain ischemia]. Moscow: Meditsina; 2001. 328 p.Дамулин И.В., Екушева Е.В. Процессы нейропластичности после инсульта.—Неврология, нейропсихиатрия, психосоматика.—2014.—С.69–74.Damulin I.V., Ekusheva E.V. Processes of neuroplasticity after a stroke. Neurology, neuropsychiatry, psychosomatics. 2014; (3): 69–74Захаров Д.В., Михайлов ВА. Роль ацетилхолиновойнейротрансмиссии в фармакотерапии когнитивной дисфункции—Обозрение психиатрии и медицинской психологии им. В.М. Бехтерева.—СПб.—2018.— № 3.— С.90–96. DOI : 10.31363/2313-7053-2018-3-90-96Zakharov D.V., Mikhailov V.A. The role of acetylcholine neurotransmission in the pharmacotherapy of cognitive dysfunction —A review of psychiatry and medical psychology. V.M. Bekhtereva.—SPb., 2018.—№ 3.—C.90–96 DOI: 10.31363 / 2313-7053- 2018-3-90-96Захаров Д.В., Михайлов В.А., Коцюбинская Ю.В. Роль ацетилхолиновойнейротрансмиссии в патогенетической терапии болезни Альцгеймера—Обозрение психиатрии и медицинской психологии им. В.М. Бехтерева.—СПб.—2018.—№ 4 .— С.93–99.Zakharov D.V., Mikhailov V.A., Kotsyubinskaya Yu.V. The role of acetylcholine neurotransmission in the pathogenetic treatment of Alzheimer’s disease—A review of psychiatry and medical psychology. V.M. Bekhtereva.—St. Petersburg., 2018.—No. 4.—P.93– 99Кадыков А.С., Шахпаронова Н.В. Реабилитация после инсульта.—Русский медицинский журнал.—2003.—№11.—С.1390–1394.Kadykov A.S., Shakhparonov N.V. Rehabilitation after a stroke. Russian medical journal. 2003; 11 (25): 1390–4.Левин О.С., Батукаева Л.А., Аникина М.А., Юнищенко Н.А. Эффективность и безопасность холин-альфосерата (Cereton) у пациентов с болезнью Паркинсона с когнитивными нарушениями. — NeurosciBehavPhysiology.— 2011.—Т.41.—С.47-51.Levin O.S., Batukayeva L.A., Anikina M.A., Yunischenko, N.A. The efficacy and safety of choline-alfos- erate (Cereton) in patients with Parkinson’s disease with cognitive impairment.—NeurosciBehavPhysiol- ogy.—2011.—T.41.—C.47-51Одинак М.М., Вознюк И.А., Пирадов М.А. и др. Многоцентровое (пилотное) исследование эффективности глиатилина при остром ишемическом инсульте.—Анналы клинической и экспериментальной неврологии.—2010.—Т.4—C.20-28.Odinak M.M., Voznyuk I.A., Piradov M.A. etal. A multicenter (pilot) study of the effectiveness of gliatilin in acute ischemic stroke \\ Annals of Clinical and Experimental Neurology—2010 Volume 4 №1 C.20-28Путилина М.В. Нейропластичность как основа ранней реабилитации пациентов после инсульта.—Журнал неврологии и психиатрии.—2011.—№12.—С.64-69.Putilina M.V. Neuroplasticity as a basis for early re- habilitation of patients after a stroke \\ Journal of Neurology and Psychiatry, 12, 2011; p. 64-69Скворцова В.И. Реперфузионная терапия ишемического инсульта. ConsiliumMedicum. 2004;6(8):610–4.Skvortsova V.I. Reperfusion therapy of ischemic stroke. Consilium Medicum. 2004; 6 (8): 610–4. [Skvortsova V.I. Reperfusion therapy of an ischemic stroke. Consilium Medicum. 2004; 6 (8): 610–4. (In Russ.)Суслина З.А., Максимова М.Ю., Федорова Т.Н. Оксидантный стресс и основные направления нейропротекции при нарушениях мозгового кровообращения. Неврологическийжурнал. 2007;12(4):3–7.Suslina Z.A., Maximova M.J., Fedorova T.N. Oxidative stress and the main directions of neuroprotection in disorders of cerebral circulation. Neurological Journal. 2007; 12 (4): 3–7. [Suslina Z.A., Maksimova M.Yu., Fedorova T.N. Oxidative stress in patients with stroke. Nevrologicheskii zhurnal. 2007; 12 (4): 3–7. (In Russ.)Чуканова Е.И., Чуканова А.С. Отдельные механизмы патогенеза формирования недостаточности мозгового кровообращения. Жур. Фарматека (кардиология / неврология).—2014.—Т.13.—С.14–20].Chukanova E.I., Chukanova A.S. Separate mechanisms of pathogenesis of cerebrovascular insufficiency. Zhur. Pharmateka (cardiology / neurology) .— 2014.—T.13.—C.14–20].Aguglia E., Ban T.A., Panzarasa R.M, Borra S., Fietland O.K. Choline alphoscerate in the treatment of menthal pathology following acute cerebrovascular accident. FunctNeurol 1993;8 (Suppl):5-24Aguglia E., Ban T.A., Panzarasa R.M, Borra S., Fietland O.K. Choline alphoscerate in the treatment of menthal pathology following acute cerebrovascular accident. FunctNeurol 1993;8 (Suppl):5-24BarbagalloSangiorgi G., Barbagallo M., Giordano M., Meli M., Panzarasa R. alphaGlycerophosphocholine in the mental recovery of cerebral ischemic attacks. An Italian multicenter clinical trial. Ann N.Y. Acad Sci. 1994; 717: 253- 269BarbagalloSangiorgi G., Barbagallo M., Giordano M., Meli M., Panzarasa R. alphaGlycerophosphocholine in the mental recovery of cerebral ischemic attacks. An Italian multicenter clinical trial. Ann N.Y. Acad Sci. 1994; 717: 253- 269Barrett K.M., Brott T.G., Brown R.D. Jr, Carter R.E., Geske J.R., Graff-Radford N.R., et al. Enhancing recovery after acute ischemic stroke with donepezil as an adjuvant therapy to standard medical care: Results of a phase iia clinical trial. J Stroke Cerebrovasc Dis. 2011; 20:177–182. [PubMed: 21295494]Barrett K.M., Brott T.G., Brown R.D. Jr, Carter R.E., Geske J.R., Graff-Radford N.R., et al. Enhancing recovery after acute ischemic stroke with donepezil as an adjuvant therapy to standard medical care: Results of a phase iia clinical trial. J Stroke Cerebrovasc Dis. 2011; 20:177–182. [PubMed: 21295494]Beltran E.J., Papadopoulos C.M., Tsai S.Y., Kartje G.L., Wolf W.A. Long-term motor improvement after stroke is enhanced by short-term treatment with the alpha-2 antagonist, atipamezole. Brain Res. 2010; 1346:174–182. [PubMed: 20510888]Beltran E.J., Papadopoulos C.M., Tsai S.Y., Kartje G.L., Wolf W.A. Long-term motor improvement after stroke is enhanced by short-term treatment with the alpha-2 antagonist, atipamezole. Brain Res. 2010; 1346:174–182. [PubMed: 20510888]Berardi N, Pizzorusso T, Maffei L. Critical periods during sensory development. Curr. Opin. Neurobiol. 2000; 10:138–145. [PubMed: 10679428]Berardi N, Pizzorusso T, Maffei L. Critical periods during sensory development. Curr. Opin. Neurobiol. 2000; 10:138–145. [PubMed: 10679428]Berthier M.L., Green C., Higueras C., Fernandez I., Hinojosa J., Martin M.C. A randomized, placebo- controlled study of donepezil in poststroke aphasia. Neurology. 2006; 67:1687–1689. [PubMed: 17101908]Berthier M.L., Green C., Higueras C., Fernandez I., Hinojosa J., Martin M.C. A randomized, placebo- controlled study of donepezil in poststroke aphasia. Neurology. 2006; 67:1687–1689. [PubMed: 17101908]Buch E., et al. Think to move: a neuromagnetic brain–computer interface (BCI) system for chronic stroke. Stroke. 2008; 39:910–917. [PubMed: 18258825]Buch E., et al. Think to move: a neuromagnetic brain–computer interface (BCI) system for chronic stroke. Stroke. 2008; 39:910–917. [PubMed: 18258825]Buonomano D.V., Merzenich M.M. Cortical plasticity: from synapses to maps. Annu. Rev. Neurosci. 1998; 21:149–186. [PubMed: 9530495]Buonomano D.V., Merzenich M.M. Cortical plasticity: from synapses to maps. Annu. Rev. Neurosci. 1998; 21:149–186. [PubMed: 9530495]Byl N., Roderick J., Mohamed O., et al. Effectiveness of sensory and motor rehabilitation of the upper limb following the principles of neuroplasticity: patients stable poststroke. Neuroreabil Neural Repair. 2003;17(3):176– 91. DOI: http://dx.doi.org/10.1177/ 0888439003257137.Byl N., Roderick J., Mohamed O., et al. Effectiveness of sensory and motor rehabilitation of the upper limb following the principles of neuroplasticity: patients stable poststroke. Neuroreabil Neural Repair. 2003;17(3):176– 91. DOI: http://dx.doi.org/10.1177/ 0888439003257137.Chollet F., Tardy J., Albucher J.F., Thalamas C, Berard E, Lamy C, et al. Fluoxetine for motor recovery after acute ischaemic stroke (flame): A randomised placebo-controlled trial. Lancet neurology. 2011; 10:123–130. [PubMed: 21216670]Chollet F., Tardy J., Albucher J.F., Thalamas C, Berard E, Lamy C, et al. Fluoxetine for motor recovery after acute ischaemic stroke (flame): A randomised placebo-controlled trial. Lancet neurology. 2011; 10:123–130. [PubMed: 21216670]Colucci L., Bosco M., Ziello A.R., Rea R., Amenta F., Fasanaro A.M. Effectiveness of nootropic drugs with cholinergic activity in treatment of cognitive deficit: a review. Journal of Experimental Pharmacology. 2012; 4:163-172.Colucci L., Bosco M., Ziello A.R., Rea R., Amenta F., Fasanaro A.M. Effectiveness of nootropic drugs with cholinergic activity in treatment of cognitive deficit: a review. Journal of Experimental Pharmacology. 2012; 4:163-172.Cools R., Roberts AC, Robbins TW. Serotoninergic regulation of emotional and behavioural control processes. Trends Cogn Sci. 2008; 12:31–40. [PubMed: 18069045]Cools R., Roberts AC, Robbins TW. Serotoninergic regulation of emotional and behavioural control processes. Trends Cogn Sci. 2008; 12:31–40. [PubMed: 18069045]Coupar F., Pollock A., van wijck F., Morris J., Langhorne P. Simultaneous bilateral training for improving arm function after stroke. Cochrane Database Systematic Reviews. 2010 Issue 4. Art. No.: CD006432. doi:10.1002/14651858. CD006432.pub2.Coupar F., Pollock A., van wijck F., Morris J., Langhorne P. Simultaneous bilateral training for improving arm function after stroke. Cochrane Database Systematic Reviews. 2010 Issue 4. Art. No.: CD006432. doi:10.1002/14651858. CD006432.pub2.Cowen P., Sherwood A.C. The role of serotonin in cognitive function: Evidence from recent studies and implications for understanding depression. J Psychopharmacol. 2013; 27:575–583. [PubMed: 23535352]Cowen P., Sherwood A.C. The role of serotonin in cognitive function: Evidence from recent studies and implications for understanding depression. J Psychopharmacol. 2013; 27:575–583. [PubMed: 23535352]Cramer S.C., Dobkin B.H., Noser E.A., Rodriguez R.W., Enney L.A. Randomized, placebocontrolled, double-blind study of ropinirole in chronic stroke. Stroke; a journal of cerebral circulation. 2009; 40:3034–3038Cramer S.C., Dobkin B.H., Noser E.A., Rodriguez R.W., Enney L.A. Randomized, placebocontrolled, double-blind study of ropinirole in chronic stroke. Stroke; a journal of cerebral circulation. 2009; 40:3034–3038Daly J.J., Wolpaw J.R. Brain-computer interfaces in neurological rehabilitation. Lancet Neurol. 2008; 7:1032–1043. [PubMed: 18835541]Daly J.J., Wolpaw J.R. Brain-computer interfaces in neurological rehabilitation. Lancet Neurol. 2008; 7:1032–1043. [PubMed: 18835541]Dam M., Tonin P., De Boni A., Pizzolato G., Casson S., Ermani M., et al. Effects of fluoxetine and maprotiline on functional recovery in poststroke hemiplegic patients undergoing rehabilitation therapy. Stroke; a journal of cerebral circulation. 1996; 27:1211–1214.Dam M., Tonin P., De Boni A., Pizzolato G., Casson S., Ermani M., et al. Effects of fluoxetine and maprotiline on functional recovery in poststroke hemiplegic patients undergoing rehabilitation therapy. Stroke; a journal of cerebral circulation. 1996; 27:1211–1214.Del Zoppo G.J. Strokeandendovascularprotec tion. N Engl J Med. 2006;354(6):353–5. DOI: http://dx.doi.org/10.1056/NEJMp058312.Del Zoppo G.J. Strokeandendovascularprotec tion. N Engl J Med. 2006;354(6):353–5. DOI: http://dx.doi.org/10.1056/NEJMp058312.Dimyan M.A., Cohen L.G. Contribution of transcranial magnetic stimulation to the understanding of functional recovery mechanisms after stroke. Neurorehabil. Neural Repair. 2010; 24:125–135. [PubMed: 19767591]Dimyan M.A., Cohen L.G. Contribution of transcranial magnetic stimulation to the understanding of functional recovery mechanisms after stroke. Neurorehabil. Neural Repair. 2010; 24:125–135. [PubMed: 19767591]Dobkin B.H. Rehabilitation after stroke. New Engl J Med. 2005;352:1677–84. DOI: http:// dx.doi.org/10.1056/NEJMcp043511.Dobkin B.H. Rehabilitation after stroke. New Engl J Med. 2005;352:1677–84. DOI: http:// dx.doi.org/10.1056/NEJMcp043511.Dobkin B.H. Confounders in rehabilitation trials of task-oriented training: lessons from the designs of the EXCITE and SCILT multicenter trials. Neurorehabil. Neural Repair. 2007; 21:3– 13. [PubMed: 17172549]Dobkin B.H. Confounders in rehabilitation trials of task-oriented training: lessons from the designs of the EXCITE and SCILT multicenter trials. Neurorehabil. Neural Repair. 2007; 21:3– 13. [PubMed: 17172549]Duman R.S., Monteggia L.M. A neurotrophic model for stress-related mood disorders. Biol Psychiatry. 2006; 59:1116–1127. [PubMed: 16631126]Duman R.S., Monteggia L.M. A neurotrophic model for stress-related mood disorders. Biol Psychiatry. 2006; 59:1116–1127. [PubMed: 16631126]Everitt B.J., Robbins T.W. Central cholinergic systems and cognition. AnnuRevPsychol 1997;48:649-684Everitt B.J., Robbins T.W. Central cholinergic systems and cognition. AnnuRevPsychol 1997;48:649-684Feeney DM, Gonzalez A, Law WA. Amphetamine, haloperidol, and experience interact to affect rate of recovery after motor cortex injury. Science. 1982; 217:855–857. [PubMed: 7100929Feeney DM, Gonzalez A, Law WA. Amphetamine, haloperidol, and experience interact to affect rate of recovery after motor cortex injury. Science. 1982; 217:855–857. [PubMed: 7100929Floel A., Cohen L.G. Recovery of function in humans: cortical stimulation and pharmacological treatments after stroke. Neurobiol. Dis. 2010; 37:243–251. [PubMed: 19520165]Floel A., Cohen L.G. Recovery of function in humans: cortical stimulation and pharmacological treatments after stroke. Neurobiol. Dis. 2010; 37:243–251. [PubMed: 19520165]Fruehwald S., Gatterbauer E., Rehak P., Baumhackl U. Early fluoxetine treatment of post-stroke depression--a three-month doubleblind placebo-controlled study with an openlabel long-term follow up. Journal of neurology. 2003; 250:347–351. [PubMed: 12638027]Fruehwald S., Gatterbauer E., Rehak P., Baumhackl U. Early fluoxetine treatment of post-stroke depression--a three-month doubleblind placebo-controlled study with an openlabel long-term follow up. Journal of neurology. 2003; 250:347–351. [PubMed: 12638027]Hakkennes S., Keating J.L. Constraint-induced movement therapy following stroke: a systematic review of randomised controlled trials. Aust. J. Physiother. 2005; 51:221–231. [PubMed: 16321129]Hakkennes S., Keating J.L. Constraint-induced movement therapy following stroke: a systematic review of randomised controlled trials. Aust. J. Physiother. 2005; 51:221–231. [PubMed: 16321129]Henderson A., Korner-Bitensky N., Levin M. virtual reality in stroke rehabilitation: a systematic review of its effectiveness for upper limb motor recovery. Top. Stroke Rehabil. 2007; 14:52–61. [PubMed: 17517575]Henderson A., Korner-Bitensky N., Levin M. virtual reality in stroke rehabilitation: a systematic review of its effectiveness for upper limb motor recovery. Top. Stroke Rehabil. 2007; 14:52–61. [PubMed: 17517575]Hesse S. Treadmill training with partial body weight support after stroke: a review. NeuroRehabilitation. 2008; 23:55–65. [PubMed: 18356589]Hesse S. Treadmill training with partial body weight support after stroke: a review. NeuroRehabilitation. 2008; 23:55–65. [PubMed: 18356589]Holloway V., et al. The reorganization of sensorimotor function in children after hemispherectomy. A functional MRI and somatosensory evoked potential study. Brain. 2000; 123:2432–2444. [PubMed: 11099446]Holloway V., et al. The reorganization of sensorimotor function in children after hemispherectomy. A functional MRI and somatosensory evoked potential study. Brain. 2000; 123:2432–2444. [PubMed: 11099446]Jorge R.E., Acion L., Moser D., Adams H.P. Jr, Robinson R.G. Escitalopram and enhancement of cognitive recovery following stroke. Archives of general psychiatry. 2010; 67:187–196. [PubMed: 20124118]Jorge R.E., Acion L., Moser D., Adams H.P. Jr, Robinson R.G. Escitalopram and enhancement of cognitive recovery following stroke. Archives of general psychiatry. 2010; 67:187–196. [PubMed: 20124118]Krakauer J.W. Motor learning: its relevance to stroke recovery and neurorehabilitation. Curr. Opin. Neurol. 2006; 19:84–90. [PubMed: 16415682]Krakauer J.W. Motor learning: its relevance to stroke recovery and neurorehabilitation. Curr. Opin. Neurol. 2006; 19:84–90. [PubMed: 16415682]Kwakkel G., Kollen B.J., Krebs H.I. Effects of robot-assisted therapy on upper limb recovery after stroke: a systematic review. Neurorehabil. Neural Repair. 2008; 22:111–121. [PubMed: 17876068]Kwakkel G., Kollen B.J., Krebs H.I. Effects of robot-assisted therapy on upper limb recovery after stroke: a systematic review. Neurorehabil. Neural Repair. 2008; 22:111–121. [PubMed: 17876068]Latimer C.P., Keeling J., Lin B., Henderson M., Hale L.A. The impact of bilateral therapy on upper limb function after chronic stroke: a systematic review. Disabil. Rehabil. 2010; 32:1221–1231. [PubMed: 20156045]Latimer C.P., Keeling J., Lin B., Henderson M., Hale L.A. The impact of bilateral therapy on upper limb function after chronic stroke: a systematic review. Disabil. Rehabil. 2010; 32:1221–1231. [PubMed: 20156045]Lee et al., Late treatment with choline alfoscerate (L-alpha glycerylphosphorylcholine, α-GPC) increases hippocampal neurogenesis and provides protection against seizure-induced neuronal death and cognitive impairment—Brain Research 1654 (2017) p.66–76Lee et al., Late treatment with choline alfoscerate (L-alpha glycerylphosphorylcholine, α-GPC) increases hippocampal neurogenesis and provides protection against seizure-induced neuronal death and cognitive impairment—Brain Research 1654 (2017) p.66–76Leipert J. Pharmacotherapy in restorative neurology. CurrOpin Neurol. 2008;21:639–43.Leipert J. Pharmacotherapy in restorative neurology. CurrOpin Neurol. 2008;21:639–43.Liepert J. Evidence-based therapies for upper extremity dysfunction. Curr. Opin. Neurol. doi:10.1097/wCO.0b013e32833ff4c4.Liepert J. Evidence-based therapies for upper extremity dysfunction. Curr. Opin. Neurol. doi:10.1097/wCO.0b013e32833ff4c4.Lo A.C., et al. Robot-assisted therapy for longterm upper-limb impairment after stroke. N. Engl. J. Med. 2010; 362:1772–1783. [PubMed: 20400552]Lo A.C., et al. Robot-assisted therapy for longterm upper-limb impairment after stroke. N. Engl. J. Med. 2010; 362:1772–1783. [PubMed: 20400552]Logue S.F., Gould T.J. The neural and genetic basis of executive function: Attention, cognitive flexibility, and response inhibition. PharmacolBiochemBehav. 2014; 123:45–54. [PubMed: 23978501]Logue S.F., Gould T.J. The neural and genetic basis of executive function: Attention, cognitive flexibility, and response inhibition. PharmacolBiochemBehav. 2014; 123:45–54. [PubMed: 23978501]Luria, A. The Restoration of Motor Functions after Brain Injury. In: Luria, A., editor. Restoration of function after brain injury. New York, NY: The Macmillan Company; 1963. p.78-116.Luria, A. The Restoration of Motor Functions after Brain Injury. In: Luria, A., editor. Restoration of function after brain injury. New York, NY: The Macmillan Company; 1963. p.78-116.Macht M.B. Effects of delta-amphetamine on hemi-decorticate, decorticate, and decerebrate cats. Am. J. Physiol. 1950; 163:731–732.Macht M.B. Effects of delta-amphetamine on hemi-decorticate, decorticate, and decerebrate cats. Am. J. Physiol. 1950; 163:731–732.Maes M., Leonard B., Fernandez A., Kubera M., Nowak G., Veerhuis R., et al. (neuro) inflammation and neuroprogression as new pathways and drug targets in depression: From antioxidants to kinase inhibitors. ProgNeuropsychopharmacolBiol Psychiatry. 2011; 35:659–663. [PubMed: 21376099]Maes M., Leonard B., Fernandez A., Kubera M., Nowak G., Veerhuis R., et al. (neuro) inflammation and neuroprogression as new pathways and drug targets in depression: From antioxidants to kinase inhibitors. ProgNeuropsychopharmacolBiol Psychiatry. 2011; 35:659–663. [PubMed: 21376099]Mandat T., Wilk A., Manowiec R., Koziarski A., Zieliƒski G., Podgórski J.K. Preliminary evaluation of risk and effectiveness of early choline alphoscerate treatment in craniocerebral injury. NeurolNeurochirPol. 2003; 37:1231-1238 [Polish]Mandat T., Wilk A., Manowiec R., Koziarski A., Zieliƒski G., Podgórski J.K. Preliminary evaluation of risk and effectiveness of early choline alphoscerate treatment in craniocerebral injury. NeurolNeurochirPol. 2003; 37:1231-1238 [Polish]Merzenich M.M., Van Vleet T.M., Nahum M. Brain plasticity-based therapeutics. Front Hum Neurosci. 2014; 8:385. [PubMed: 25018719]Merzenich M.M., Van Vleet T.M., Nahum M. Brain plasticity-based therapeutics. Front Hum Neurosci. 2014; 8:385. [PubMed: 25018719]Mikami K., Jorge R.E., Moser D.J., Arndt S., Jang M., Solodkin A., et al. Prevention of post-stroke generalized anxiety disorder, using escitalopram or problem-solving therapy. J Neuropsychiatry ClinNeurosci. 2014; 26:323–328. [PubMed: 24457590]Mikami K., Jorge R.E., Moser D.J., Arndt S., Jang M., Solodkin A., et al. Prevention of post-stroke generalized anxiety disorder, using escitalopram or problem-solving therapy. J Neuropsychiatry ClinNeurosci. 2014; 26:323–328. [PubMed: 24457590]Miller E., Murray L., Richards L., et al. Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: a scientific statement from the American Heart Association. Stroke. 2010;41:2402–48.Miller E., Murray L., Richards L., et al. Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: a scientific statement from the American Heart Association. Stroke. 2010;41:2402–48.Miyai I., Reding R. Effects of antidepressants on functional recovery following stroke. J Neuro Rehab. 1998; 12:5–13.Miyai I., Reding R. Effects of antidepressants on functional recovery following stroke. J Neuro Rehab. 1998; 12:5–13.Moseley A.M., Stark A., Cameron I.D., Pollock A. Treadmill training and body weight support for walking after stroke. Cochrane Database Systematic Reviews. Issue 4. Art. No.: CD002840. doi: 10.1002/14651858. CD002840.pub2 (2005)Moseley A.M., Stark A., Cameron I.D., Pollock A. Treadmill training and body weight support for walking after stroke. Cochrane Database Systematic Reviews. Issue 4. Art. No.: CD002840. doi: 10.1002/14651858. CD002840.pub2 (2005)Murphy T.H., Corbett D. Plasticity during strokere covery: from synapse to behaviour. Nature Rev Neurosci. 2009;10:861–72. DOI: http://dx.doi.org/10.1038/ nrn2735Murphy T.H., Corbett D. Plasticity during strokere covery: from synapse to behaviour. Nature Rev Neurosci. 2009;10:861–72. DOI: http://dx.doi.org/10.1038/ nrn2735Nudo R.J., Wise B.M., SiFuentes F., Milliken G.W. Neural substrates for the effects of rehabilitative training on motor recovery after ischemic infarct. Science. 1996; 272:1791–1794. [PubMed: 8650578]Nudo R.J., Wise B.M., SiFuentes F., Milliken G.W. Neural substrates for the effects of rehabilitative training on motor recovery after ischemic infarct. Science. 1996; 272:1791–1794. [PubMed: 8650578]Pariente J., Loubinoux I., Carel C., Albucher J., Leger A., Manelfe C., et al. Fluoxetine modulates motor performance and cerebral activation of patients recovering from stroke. Annals of neurology. 2001; 50:718–729. [PubMed: 11761469]Pariente J., Loubinoux I., Carel C., Albucher J., Leger A., Manelfe C., et al. Fluoxetine modulates motor performance and cerebral activation of patients recovering from stroke. Annals of neurology. 2001; 50:718–729. [PubMed: 11761469]Payne B.R., Lomber S.G. Reconstructing functional systems after lesions of cerebral cortex. Nat. Rev. Neurosci. 2001; 2:911–919. [PubMed: 11733798]Payne B.R., Lomber S.G. Reconstructing functional systems after lesions of cerebral cortex. Nat. Rev. Neurosci. 2001; 2:911–919. [PubMed: 11733798]Riley J.D., Le V., Der-Yeghiaian L., etal. Ana tomyofstrokeinjurypredictsgainsfromtherapy. Stroke. 2011;42(2):421–6. DOI:http://dx.doi. org/10.1161/STROKEAHA.110.599340Riley J.D., Le V., Der-Yeghiaian L., etal. Ana tomyofstrokeinjurypredictsgainsfromtherapy. Stroke. 2011;42(2):421–6. DOI:http://dx.doi. org/10.1161/STROKEAHA.110.599340Rijntjes M. Mechanismsofrecoveryinstrokepatient swithhemiparesisoraphasia: newinsights, oldquest ionsandthemeaningoftherapies. CurrOpinNeurol. 2006;19(1):76–83. DOI: http://dx.doi. org/10.1097/01. wco.0000203886.28068.38.Rijntjes M. Mechanismsofrecoveryinstrokepatient swithhemiparesisoraphasia: newinsights, oldquest ionsandthemeaningoftherapies. CurrOpinNeurol. 2006;19(1):76–83. DOI: http://dx.doi. org/10.1097/01. wco.0000203886.28068.38.Restemeyer C., Weiller C., Liepert J. No effect of a levodopa single dose on motor performance and motor excitability in chronic stroke A double-blind placebo-controlled cross-over pilot study. Restorative neurology and neuroscience. 2007; 25:143–150. [PubMed: 17726273]Restemeyer C., Weiller C., Liepert J. No effect of a levodopa single dose on motor performance and motor excitability in chronic stroke A double-blind placebo-controlled cross-over pilot study. Restorative neurology and neuroscience. 2007; 25:143–150. [PubMed: 17726273]Robinson R.G., Jorge R.E., Moser D.J., Acion L., Solodkin A., Small S.L., et al. Escitalopram and problem-solving therapy for prevention of poststroke depression: A randomized controlled trial. Jama. 2008; 299:2391–2400. [PubMed: 18505948]Robinson R.G., Jorge R.E., Moser D.J., Acion L., Solodkin A., Small S.L., et al. Escitalopram and problem-solving therapy for prevention of poststroke depression: A randomized controlled trial. Jama. 2008; 299:2391–2400. [PubMed: 18505948]Santarelli L., Saxe M., Gross C., Surget A., Battaglia F., Dulawa S., et al. Requirement of hippocampal neurogenesis for the behavioral effects of antidepressants. Science. 2003; 301:805–809. [PubMed: 12907793]Santarelli L., Saxe M., Gross C., Surget A., Battaglia F., Dulawa S., et al. Requirement of hippocampal neurogenesis for the behavioral effects of antidepressants. Science. 2003; 301:805–809. [PubMed: 12907793]Saver J.L. Citicoline: update on a promising and widely available agent for neuroprotection and neurorepair. Rev. Neurol. Dis. 2008; 5:167–177. [PubMed: 19122569]Saver J.L. Citicoline: update on a promising and widely available agent for neuroprotection and neurorepair. Rev. Neurol. Dis. 2008; 5:167–177. [PubMed: 19122569]Scheidtmann K., Fries W., Muller F., Koenig E. Effect of levodopa in combination with physiotherapy on functional motor recovery after stroke: A prospective, randomised, double-blind study. Lancet. 2001; 358:787–790. [PubMed: 11564483]Scheidtmann K., Fries W., Muller F., Koenig E. Effect of levodopa in combination with physiotherapy on functional motor recovery after stroke: A prospective, randomised, double-blind study. Lancet. 2001; 358:787–790. [PubMed: 11564483]Seitz R.J. How imaging will guide rehabilitation. Curr. Opin. Neurol. 2010; 23:79–86. [PubMed: 19926990]Seitz R.J. How imaging will guide rehabilitation. Curr. Opin. Neurol. 2010; 23:79–86. [PubMed: 19926990]Sirtori V., Corbetta D., Moja L., Gatti R. Constraint-induced movement therapy for upper extremities in stroke patients. Cochrane Database Systematic Reviews. 2009 Issue 4. Art. No.: CD004433. doi:10.1002/14651858. CD004433.pub2.Sirtori V., Corbetta D., Moja L., Gatti R. Constraint-induced movement therapy for upper extremities in stroke patients. Cochrane Database Systematic Reviews. 2009 Issue 4. Art. No.: CD004433. doi:10.1002/14651858. CD004433.pub2.Smirnakis S.M., et al. Lack of long-term cortical reorganization after macaque retinal lesions. Nature. 2005; 435:300–307. [PubMed: 15902248]Smirnakis S.M., et al. Lack of long-term cortical reorganization after macaque retinal lesions. Nature. 2005; 435:300–307. [PubMed: 15902248]Sonde L., Lokk J. Effects of amphetamine and/ or l-dopa and physiotherapy after stroke—a blinded randomized study. ActaNeurol Scand. 2007; 115:55–59. [PubMed: 17156266]Sonde L., Lokk J. Effects of amphetamine and/ or l-dopa and physiotherapy after stroke—a blinded randomized study. ActaNeurol Scand. 2007; 115:55–59. [PubMed: 17156266]Teasell R. et al. Top Stroke Rehabil 2012;19(6):457–462].Teasell R. et al. Top Stroke Rehabil 2012;19(6):457–462].Tomasina C., Manzino M., Novello P., Pastorino P. Studio clinicodell’efficaciaterapeutica e dellatol lerabilitàdellacolinaalfoscerato in 15 soggetti con compromissionedellefunzioni cognitive successiva ad ischemia cerebralefocaleacuta. RivistaNeurop sichiatriaSciAffini 1991; 37:21-28.Tomasina C., Manzino M., Novello P., Pastorino P. Studio clinicodell’efficaciaterapeutica e dellatol lerabilitàdellacolinaalfoscerato in 15 soggetti con compromissionedellefunzioni cognitive successiva ad ischemia cerebralefocaleacuta. RivistaNeurop sichiatriaSciAffini 1991; 37:21-28.Tomassoni D., Avola R., Mignini F., Parnetti L., Amenta F. Effect of treatment with choline alphoscerate on hippocampus microanatomy and glial reaction in spontaneously hypertensive rats.—Brain Res.—2006.—Vol.1120.—P.183- 190Tomassoni D., Avola R., Mignini F., Parnetti L., Amenta F. Effect of treatment with choline alphoscerate on hippocampus microanatomy and glial reaction in spontaneously hypertensive rats.—Brain Res.—2006.—Vol.1120.—P.183- 190Tritsch N.X., Sabatini B.L. Dopaminergic modulation of synaptic transmission in cortex and striatum. Neuron. 2012; 76:33–50. [PubMed: 23040805]Tritsch N.X., Sabatini B.L. Dopaminergic modulation of synaptic transmission in cortex and striatum. Neuron. 2012; 76:33–50. [PubMed: 23040805]Vega et al., Nerve growth factor receptor immunoreactivity in the cerebellar cortex of aged rats: effect of choline alfoscerate treatment Mechanisms of Ageing and Development, 69 (1993) 119-127Vega et al., Nerve growth factor receptor immunoreactivity in the cerebellar cortex of aged rats: effect of choline alfoscerate treatment \\ Mechanisms of Ageing and Development, 69 (1993) 119-127Volpe B.T., et al. Robotic devices as therapeutic and diagnostic tools for stroke recovery. Arch. Neurol. 2009; 66:1086–1090. [PubMed: 19752297] Volpe B.T., et al. Robotic devices as therapeutic and diagnostic tools for stroke recovery. Arch. Neurol. 2009; 66:1086–1090. [PubMed: 19752297]Volpe B.T., et al. Robotic devices as therapeutic and diagnostic tools for stroke recovery. Arch. Neurol. 2009; 66:1086–1090. [PubMed: 19752297] Volpe B.T., et al. Robotic devices as therapeutic and diagnostic tools for stroke recovery. Arch. Neurol. 2009; 66:1086–1090. [PubMed: 19752297]Wang L.E., Fink G.R., Diekhoff S., Rehme A.K., Eickhoff S.B., Grefkes C. Noradrenergic enhancement improves motor network connectivity in stroke patients. Annals of neurology. 2011; 69:375–388. [PubMed: 21387380]Wang L.E., Fink G.R., Diekhoff S., Rehme A.K., Eickhoff S.B., Grefkes C. Noradrenergic enhancement improves motor network connectivity in stroke patients. Annals of neurology. 2011; 69:375–388. [PubMed: 21387380]Wang W., et al. Neural interface technology for rehabilitation: exploiting and promoting neuroplasticity. Phys. Med. Rehabil. Clin. N. Am. 2010; 21:157–178. [PubMed: 19951784]Wang W., et al. Neural interface technology for rehabilitation: exploiting and promoting neuroplasticity. Phys. Med. Rehabil. Clin. N. Am. 2010; 21:157–178. [PubMed: 19951784]Wissel J., Olver J., Stibrant Sunnerhagen K. Navigating the poststroke continuum of care. J Stroke Cerebrovasc Dis. 2013;22(1):1–8. DOI: http://dx.doi.org/10.1016/j.jstrokecerebrovasd is.2011.05.021Wissel J., Olver J., Stibrant Sunnerhagen K. Navigating the poststroke continuum of care. J Stroke Cerebrovasc Dis. 2013;22(1):1–8. DOI: http://dx.doi.org/10.1016/j.jstrokecerebrovasd is.2011.05.021Whyte E.M., Lenze E.J., Butters M., Skidmore E., Koenig K., Dew M.A., et al. An open-label pilot study of acetylcholinesterase inhibitors to promote functional recovery in elderly cognitively impaired stroke patients. Cerebrovascular diseases. 2008; 26:317–321. [PubMed: 18667813]Whyte E.M., Lenze E.J., Butters M., Skidmore E., Koenig K., Dew M.A., et al. An open-label pilot study of acetylcholinesterase inhibitors to promote functional recovery in elderly cognitively impaired stroke patients. Cerebrovascular diseases. 2008; 26:317–321. [PubMed: 18667813]Zimmermann-Schlatter A., Schuster C., Puhan M.A., Siekierka E., Steurer J. Efficacy of motor imagery in post-stroke rehabilitation: a systematic review. J. Neuroeng. Rehabil. 2008; 5:8. [PubMed: 18341687]Zimmermann-Schlatter A., Schuster C., Puhan M.A., Siekierka E., Steurer J. Efficacy of motor imagery in post-stroke rehabilitation: a systematic review. J. Neuroeng. Rehabil. 2008; 5:8. [PubMed: 18341687]Zorowitz R.D. Road to recovery: drugs used in stroke rehabilitation. Expert Rev. Neurother. 2004; 4:219–231. [PubMed: 15853563]Zorowitz R.D. Road to recovery: drugs used in stroke rehabilitation. Expert Rev. Neurother. 2004; 4:219–231. [PubMed: 15853563]

The authors declare that there are no conflicts of interest present.