The Implications of Microglial Regulation in Neuroplasticity-Dependent Stroke Recovery

Stroke causes varying degrees of neurological deficits, leading to corresponding dysfunctions. There are different therapeutic principles for each stage of pathological development. Neuroprotection is the main treatment in the acute phase, and functional recovery becomes primary in the subacute and chronic phases. Neuroplasticity is considered the basis of functional restoration and neurological rehabilitation after stroke, including the remodeling of dendrites and dendritic spines, axonal sprouting, myelin regeneration, synapse shaping, and neurogenesis. Spatiotemporal development affects the spontaneous rewiring of neural circuits and brain networks. Microglia are resident immune cells in the brain that contribute to homeostasis under physiological conditions. Microglia are activated immediately after stroke, and phenotypic polarization changes and phagocytic function are crucial for regulating focal and global brain inflammation and neurological recovery. We have previously shown that the development of neuroplasticity is spatiotemporally consistent with microglial activation, suggesting that microglia may have a profound impact on neuroplasticity after stroke and may be a key therapeutic target for post-stroke rehabilitation. In this review, we explore the impact of neuroplasticity on post-stroke restoration as well as the functions and mechanisms of microglial activation, polarization, and phagocytosis. This is followed by a summary of microglia-targeted rehabilitative interventions that influence neuroplasticity and promote stroke recovery.

Automated summary

Stroke can cause neurological deficits and dysfunctions at different stages of pathological development. Neuroprotection is the main treatment in the acute phase, while functional recovery becomes the focus in the subacute and chronic phases. Neuroplasticity, including dendritic and axonal remodeling, synapse shaping, and neurogenesis, is considered the basis for post-stroke restoration. Microglia play a crucial role in regulating brain inflammation and neurological recovery after stroke, and their activation and phagocytic function are closely related to neuroplasticity. This review explores the impact of neuroplasticity on post-stroke restoration and discusses the functions and mechanisms of microglial activation, polarization, and phagocytosis, as well as microglia-targeted rehabilitative interventions that promote stroke recovery.