Role of arousal in recovery of motor function after brain injuries

What is the role of brain mechanisms underlying arousal in recovery of motor function after structural brain injuries?

Andrew M. Goldfine and Nicholas D. Schiff

Current Opinion in Neurology 24, 564-569 (2011)


Purpose of review Standard neurorehabilitation approaches have limited impact on motor recovery in patients with severe injuries. Consideration of the contributions of impaired arousal offers a novel approach to understand and enhance recovery.

Recent findings Animal and human neuroimaging studies are elucidating the neuroanatomical bases of arousal and of arousal regulation, the process by which the cerebrum mobilizes resources. Studies of patients with disorders of consciousness have revealed that recovery of these processes is associated with marked improvements in motor performance. Recent studies have also demonstrated that patients with less severe brain injuries also have impaired arousal, manifesting as diminished sustained attention, fatigue and apathy. In these less severely injured patients it is difficult to connect disorders of arousal with motor recovery due to a lack of measures of arousal independent of motor function.

Summary Arousal impairment is common after brain injury and likely plays a significant role in recovery of motor function. A more detailed understanding of this connection will help to develop new therapeutic strategies applicable for a wide range of patients. This requires new tools that continuously and objectively measure arousal in patients with brain injury, to correlate with detailed measures of motor performance and recovery.

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