Stroke after effects11/14/2022 Both age-standardized mortality and stroke prevalence rates have significantly decreased over the last three decades owing to better prevention of cardiovascular diseases in general and improvements in the acute stroke setting, e.g., specialized facilities (i.e., stroke units) and the development of recanalizing therapies, i.e., thrombolysis and thrombectomy. The Global Burden of Disease (GBD) study group recently demonstrated that with higher age, stroke holds a paramount role concerning life years lost due to mortality or morbidity (disease-adjusted life years, DALY Fig. About two-thirds of all stroke patients are older than 65 years (e.g., CDC Stroke Statistics, Australian Stroke Foundation). In Europe and the United States of America, the average age of all stroke patients is around 70 to 75 years (US National Center of Health Statistics, UK Stroke Association, German Medical Chamber). Like for other vascular diseases, stroke prevalence and incidence are strongly age-related. Stroke is the most common cause for acute hospitalization in neurology departments in high-income countries. The review also highlights important limitations of current models, and finally closes with possible solutions and future directions. Finally, neurotechnology-based treatment strategies allowing patient-tailored interventions to achieve enhanced treatment responses are discussed. We demonstrate that the combination of neuroimaging and neurostimulation techniques allows a better understanding of how brain plasticity can be modulated to promote the reorganization of neural networks. We discuss current concepts of how the brain reorganizes its functional architecture to overcome stroke-induced deficits, and also present evidence for maladaptive effects interfering with recovery. This review provides a comprehensive survey of recent developments in the field of stroke recovery using neuroimaging and non-invasive brain stimulation. For developing novel, neurobiologically informed strategies to promote recovery of function, an improved understanding of the mechanisms enabling plasticity and recovery is mandatory. The most critical driver of functional recovery post-stroke is neural reorganization. As the absolute number of stroke survivors is likely to further increase due to the demographic changes in our aging societies, new strategies are needed in order to improve neurorehabilitation. Although the treatment of acute stroke has been improved considerably, the majority of patients to date are left disabled with a considerable impact on functional independence and quality of life. Stroke is a leading cause of acquired, permanent disability worldwide.
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