Semin Neurol 2021; 41(02): 157-166
DOI: 10.1055/s-0041-1725140
Review Article

Principles of Neural Repair and Their Application to Stroke Recovery Trials

1  Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
4  VA RR&D Center for Neurorestoration and Neurotechnology, Rehabilitation R&D Service, Department of VA Medical Center, Providence, Rhode Island
Steven C. Cramer
2  Department of Neurology, University of California, Los Angeles, California
3  California Rehabilitation Institute, Los Angeles, California
› Author Affiliations


Neural repair is the underlying therapeutic strategy for many treatments currently under investigation to improve recovery after stroke. Repair-based therapies are distinct from acute stroke strategies: instead of salvaging threatened brain tissue, the goal is to improve behavioral outcomes on the basis of experience-dependent brain plasticity. Furthermore, timing, concomitant behavioral experiences, modality specific outcome measures, and careful patient selection are fundamental concepts for stroke recovery trials that can be deduced from principles of neural repair. Here we discuss core principles of neural repair and their implications for stroke recovery trials, highlighting related issues from key studies in humans. Research suggests a future in which neural repair therapies are personalized based on measures of brain structure and function, genetics, and lifestyle factors.


D.J.L. reports no disclosures. S.C.C. serves as a consultant for Constant Therapeutics, Neurolutions, MicroTransponder, SanBio, Fujifilm Toyama Chemical Co., NeuExcell, Medtronics, and TRCare.

Publication History

Publication Date:
04 March 2021 (online)

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