Stroke is among the most common causes of adult disability worldwide, and its disease burden is shifting towards that of a long-term condition. Therefore, the development of approaches to enhance recovery and augment neural repair after stroke will be critical. Recovery after stroke involves complex interrelated systems of neural repair. There are changes in both structure (at the molecular, cellular, and tissue levels) and function (in terms of excitability, cortical maps, and networks) that occur spontaneously within the brain. Several approaches to augment neural repair through enhancing these changes are under study. These include identifying novel drug targets, implementing rehabilitation strategies, and developing new neurotechnologies. Each of these approaches has its own array of different proposed mechanisms. Current investigation has emphasized both cellular and circuit-based targets in both gray and white matter, including axon sprouting, dendritic branching, neurogenesis, axon preservation, remyelination, blood brain barrier integrity, blockade of extracellular inhibitory signals, alteration of excitability, and promotion of new brain cortical maps and networks. Herein, we review for clinicians recovery after stroke, basic elements of spontaneous neural repair, and ongoing work to augment neural repair. Future study requires alignment of basic, translational, and clinical research. The field continues to grow while becoming more clearly defined. As thrombolysis changed stroke care in the 1990 s and thrombectomy in the 2010 s, the augmentation of neural repair and recovery after stroke may revolutionize care for these patients in the coming decade.

中文翻译：

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转化中风后神经修复的概念：恢复的结构和功能目标。


中风是全球成人残疾最常见的原因之一，其疾病负担正在转向长期疾病。因此，开发促进中风后恢复和增强神经修复的方法至关重要。中风后的恢复涉及复杂的相互关联的神经修复系统。大脑内自发发生的结构（在分子、细胞和组织水平）和功能（在兴奋性、皮质图和网络方面）都发生了变化。目前正在研究几种通过增强这些变化来增强神经修复的方法。其中包括确定新的药物靶点、实施康复策略和开发新的神经技术。这些方法中的每一种都有其自己的一系列不同的提议机制。目前的研究强调灰质和白质中基于细胞和回路的目标，包括轴突萌芽、树突分支、神经发生、轴突保存、髓鞘再生、血脑屏障完整性、细胞外抑制信号的阻断、兴奋性的改变和促进新的大脑皮层图和网络。在此，我们回顾了临床医生中风后的恢复、自发神经修复的基本要素以及正在进行的增强神经修复的工作。未来的研究需要基础研究、转化研究和临床研究的结合。该领域不断发展，同时定义也​​更加清晰。正如 20 世纪 90 年代的溶栓治疗和 2010 年代的血栓切除术改变了中风护理一样，中风后神经修复和恢复的增强可能会在未来十年彻底改变这些患者的护理。