Cerebrovascular disease: Edited by Patrik MichelHow imaging will guide rehabilitationSeitz, Rüdiger Ja,bAuthor Information aDepartment of Neurology, University Hospital Düsseldorf, Germany bBiomedical Research Centre, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany Correspondence to Dr Rüdiger J. Seitz, Department of Neurology, University Hospital Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany Tel: +49 211 81 18974; fax: +49 211 81 18485; e-mail: [email protected] Current Opinion in Neurology: February 2010 - Volume 23 - Issue 1 - p 79-86 doi: 10.1097/WCO.0b013e328334c84d Buy Metrics Abstract Purpose of review Human ischemic stroke is a multistage disorder with different options for recovery. Imaging has opened a window to explore the pathophysiology and recovery mechanisms of ischemic stroke in vivo. Recent findings It was shown that in the acute phase, arterial recanalization and reperfusion are the most important determinants for recovery. This is followed by functional and structural changes in the perilesional tissue and in large-scale bihemispheric networks that continue with different dynamics for weeks to months. Evidence is presented that the behavioral gains induced by repetitive and mental training are paralleled by changes in functional representations. Summary This review emphasizes that neuroimaging has a great potential for monitoring the hemodynamic, functional and structural factors determining recovery from stroke. It is shown that combining neuroimaging with electrophysiological methods will be instrumental for developing neuroscience-based strategies in rehabilitation. © 2010 Lippincott Williams & Wilkins, Inc.