Stroke in the Motor Cortex: What to Expect & How to Recover

A stroke in the motor cortex will cause difficulties with muscle movement and coordination.

Fortunately, because of the brain’s neuroplasticity, it is usually possible to reverse many of the effects of a motor cortex stroke, with a lot of hard work and time.

This article will explain what the motor cortex is, and how you can harness your brain’s natural repair mechanism to regain control of your movement.

What is the Motor Cortex?

The motor cortex is a strip of brain tissue located in the frontal lobe. There are three sections that comprise the motor cortex. These are the:

• Primary motor cortex
• Premotor cortex
• Supplementary motor area

These three areas are responsible for initiating and coordinating voluntary movements. Voluntary movements include everything from moving your hands and legs to controlling facial expressions and even some swallowing motions.

Signals from the primary motor cortex cross over the body’s midline to activate muscles on the opposite side of the body.

This means that the movements on the right side of your body are controlled by the left hemisphere of the primary motor cortex, and vice versa. Therefore, if a stroke occurs in the left hemisphere, you will have difficulty moving your right side.

How the Motor Cortex Works

The different sections of the motor cortex control different aspects of movement. For example, the premotor cortex is responsible for planning movement, and the primary motor cortex is in charge of executing that movement.

The primary motor cortex is arranged in such a way that different parts of the cortex control different parts of the body. However, not every part has equal amounts of brain matter devoted to it.

Complex movements that require more precise control take up larger amounts of space in the brain than simple motions do. For example, a significant portion of the motor cortex is devoted to finger movements and facial expressions, while a smaller portion of the brain is responsible for leg motions, since these movements are less precise.     

This fact explains why many stroke patients struggle with fine motor control or facial paralysis. Because those motions are controlled by a larger portion of the motor cortex, they have a much higher likelihood of becoming damaged during a stroke.

On the other hand, with leg control, only a small amount of brain matter controls it. So a stroke must occur in that small area in order to affect the leg.

Effects of Stroke in the Motor Cortex

A stroke in the motor cortex can cause a variety of physical effects, some more serious than others.

Some common secondary effects of motor cortex damage include:

• Hemiparesis. This refers to weakness on one side of the body. If a stroke has damaged the left motor cortex, the patient may have trouble lifting their right arm, moving the fingers on their right hand, controlling their right leg movements, and the entire right side of their face might droop. Hemiparesis can also affect trunk movements, so patients with this condition may have trouble balancing due to weakness through their core muscles on the affected side.
• Spasticity. Spasticity occurs after a loss or disruption of communication between the brain and muscles. With spasticity, the muscles are in a constant state of contraction. If this situation persists, the muscle fibers can shorten and contractures will set in.
• Loss of Fine Motor Skills. When a stroke occurs in the motor cortex, the person usually loses the ability to move their hands, fingers, and wrists. The ability to move each muscle individually is known as fine motor skills.
• Speech problems. The motor cortex controls many of the muscles used during speech. Therefore, if a stroke damages this area, speech difficulties can occur.  
• Incontinence. A stroke in the motor cortex can also weaken the muscles that control bowel and bladder functions. This effect usually occurs immediately after stroke, but typically fades after the brain has had time to heal.

As you can see, motor cortex damage can lead to a wide range of symptoms. The type of symptoms you experience will depend on the precise location of the stroke. Fortunately though, you can treat these issues through physical, occupational, and speech therapy.

Treating the Effects of Stroke through Neuroplasticity

While it’s not possible to revive dead neurons in the motor cortex,  it is still possible to regain lost function after stroke.

This can occur because the brain possesses a remarkable healing ability known as neuroplasticity. Neuroplasticity allows the brain to reorganize neurons and compensate for damaged areas.

Neuroplasticity is the basic principle behind many therapy protocols. It’s activated through a simple but demanding protocol: repetitious exercise.

At the beginning of stroke recovery, the therapist will help you practice activating a particular muscle group, such as your hand muscles. This will require significant effort and concentration at first, because the brain will be establishing new neural pathways.

But fortunately, the more you practice that movement, the more you will reinforce those pathways. After enough time, the new pathways will be fully established and the movement will become much easier to perform.

In the end then, the best way to overcome a stroke in the motor cortex is to engage neuroplasticity through consistent exercise.

Why Early Intervention Is Crucial

During the first three months after stroke, the brain enters a heightened state of plasticity. This means that therapy will have a more visible impact, and patients can make faster progress.

Therefore, it is crucial to begin physical, occupational, and speech therapy (if applicable to you) as soon as possible after a stroke in the motor cortex. This allows patients to take advantage of their heightened plasticity.

Stroke patients should also try to practice home therapy as much as possible in the early days of their recovery. The more consistently you activate neuroplasticity, the more progress you will make. However, even if you are past the early phase of recovery, it’s still possible to recover when you pick things back up.

Many therapists recommend going to both outpatient therapy and participating in a home exercise regimen for best results. Rehab technology like Flint Rehab’s FitMi home therapy is attractive for patients recovering from this type of stroke because it motivates intense repetition of therapeutic exercises.

Recovering from a Stroke in the Motor Cortex

A stroke in the motor cortex can affect nearly every muscle in the body. This can cause weakness, paralysis, and other physical problems.

The effects of this type of stroke are serious. However, many of them can be reversed by activating neuroplasticity through exercise.

With enough practice, you can help your brain rewire itself until eventually, you regain the strength to move your body once again.