Plasticity for recovery, plasticity for development: cognitive outcome in twins discordant for mid-childhood ischemic stroke.

Cognitive and language profiles in a set of likely monozygotic 13-year-old twins raised together and discordant for an extensive left hemisphere stroke are described 6 years post-stroke. Recovery differed across four skill profiles, created based on a model of plasticity. Full recovery of lost skills and full or partial development of new skills typically involved either semantic memory or right hemisphere lateralized functions such as visual perception skills. Limited development of new skills and full or partial recovery of lost skills took place in either active verbal memory or oral language skills that are left hemisphere lateralized. Language skills concerned with real-time lexical retrieval, or the use and understanding of morphology and grammar, phonological processing skills, and auditory working memory were least likely to recover and continue to develop.