Neurorehabilitation

Brigid Dwyer, MD

Douglas Katz, MD

The origins of neurological dysfunction resulting from neural injury and disease are complex, as are the processes involved in neural repair, reorganization, and recovery of function. Neurorehabilitation and neural repair involve a set of molecular, cellular, network, and systemic responses that are becoming better characterized with advances in rehabilitation neuroscience. Application of this knowledge has been increasingly beneficial in shaping more effective clinical rehabilitation. Utilization of new technologies, such as advanced neuroimaging techniques, robotics, brain–computer interfaces, and smart prostheses, will transform neurorehabilitation going forward.

Neurorehabilitation encompasses several objectives: to prevent further losses; to reverse damage where possible; to restore function; to compensate with new strategies; and to circumvent and adapt to functional impairments caused by neurological injury or disease. These efforts often extend beyond the immediate circumstances of clinical care and carry forward over a patient's entire lifetime. Neurological rehabilitation should be an important component and continual influence in systems of care for individuals with neurological disorders.

In this issue of Seminars in Neurology, we include articles by leading investigators and clinicians in the field that review several areas of importance in neurorehabilitation, pertaining to neuroscience, assessment, and treatment. These articles touch on several neurological disorders, including stroke, traumatic brain injury (TBI), Parkinson's disease, and multiple sclerosis. The issue opens with a discussion of applying familiar clinical neurologic principles of diagnosis and prognosis to better characterize functional impairments and guide rehabilitation treatment. Several articles offer insightful discussions of neuroplasticity, as well as molecular substrates of recovery, and how they might be best manipulated and individualized to improve functional recovery, particularly for motor problems after stroke. Two articles discuss rehabilitation after mild TBI and for those with persistent postconcussive symptoms, addressing both adult and pediatric populations. Two articles discuss evidence for best practices in rehabilitation to improve and maintain function in chronic and neurodegenerative conditions, such as Parkinson's disease and multiple sclerosis. Finally, there is an article on the application of new technologies in neurorehabilitation with a discussion of the development of brain–computer interfaces.

We wish to thank these authors for their exceptional contributions to this issue, including a commitment to offering practical clinical insights. We also thank Dr. Greer for his thoughtful guidance throughout the editing process. We hope that you find these reviews informative and thought-provoking.

Publication History

Article published online:
08 April 2021