Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:

Wednesday, February 29, 2012

GSK3 as a Sensor Determining Cell Fate in the Brain

More stuff to research on hyperacute therapies.
Glycogen synthase kinase 3 (GSK3) is an unusual serine/threonine kinase that controls many neuronal functions, including neurite outgrowth, synapse formation, neurotransmission, and neurogenesis. It mediates these functions by phosphorylating a wide range of substrates involved in gene transcription, metabolism, apoptosis, cytoskeletal dynamics, signal transduction, lipid membrane dynamics, and trafficking, amongst others. This complicated list of diverse substrates generally follow a more simple pattern: substrates negatively regulated by GSK3-mediated phosphorylation favor a proliferative/survival state, while substrates positively regulated by GSK3 favor a more differentiated/functional state. Accordingly, GSK3 activity is higher in differentiated cells than undifferentiated cells and physiological (Wnt, growth factors) and pharmacological inhibitors of GSK3 promote the proliferative capacity of embryonic stem cells. In the brain, the level of GSK3 activity influences neural progenitor cell proliferation/differentiation in neuroplasticity and repair, as well as efficient neurotransmission in differentiated adult neurons. While defects in GSK3 activity are unlikely to be the primary cause of neurodegenerative diseases, therapeutic regulation of its activity to promote a proliferative/survival versus differentiated/mature functional environment in the brain could be a powerful strategy for treatment of neurodegenerative and other mental disorders.

Genetic Manipulation of Cell Death and Neuroplasticity Pathways in Traumatic Brain Injury

Something similar needs to be done for stroke.

Traumatic brain injury (TBI) initiates a complex cascade of secondary neurodegenerative mechanisms contributing to cell dysfunction and necrotic and apoptotic cell death. The injured brain responds by activating endogenous reparative processes to counter the neurodegeneration or remodel the brain to enhance functional recovery. A vast array of genetically altered mice provide a unique opportunity to target single genes or proteins to better understand their role in cell death and endogenous repair after TBI. Among the earliest targets for transgenic and knockout studies in TBI have been programmed cell death mediators, such as the Bcl-2 family of proteins, caspases, and caspase-independent pathways. In addition, the role of cell cycle regulatory elements in the posttraumatic cell death pathway has been explored in mouse models. As interest grows in neuroplasticity in TBI, the use of transgenic and knockout mice in studies focused on gliogenesis, neurogenesis, and the balance of growth-promoting and growth-inhibiting molecules has increased in recent years. With proper consideration of potential effects of constitutive gene alteration, traditional transgenic and knockout models can provide valuable insights into TBI pathobiology. Through increasing sophistication of conditional and cell-type specific genetic manipulations, TBI studies in genetically altered mice will be increasingly useful for identification and validation of novel therapeutic targets.

Mending the brain with a mechanical glove

Just think, students came up with this.

Northeastern University student-researchers have created a post-stroke rehabilitation glove designed to increase hand strength through finger extension and improve cognitive ability to complete everyday tasks such as picking up a glass, turning a doorknob or unscrewing a soda bottle.

The innovative device, dubbed “Excelsior,” was designed for a senior capstone project under the direction of Constantinos Mavroidis, Distinguished Professor of Engineering, and Richard Ranky, a mechanical engineering doctoral candidate. The undergraduate team members included Aaron Bickel, Abhishek Singhal, Craig Pacella and Nisha Parekh, whose work was supported by a three-year, $270,000 grant from the National Science Foundation.

According to the Centers for Disease Control and Prevention, some 800,000 stroke cases occur in the United States each year. Ranky said survivors require physical therapy and ongoing exercise to regain mobility and dexterity. As he put it, “A major goal for patients post-stroke is regaining their fine motor control.”

Excelsior – which was developed using 3-D additive manufacturing with embedded sensors and can be customized to fit a patient’s hand – was designed with that goal in mind.

To improve cognitive function, users match colored LEDs (light-emitting diodes) on the device’s fingertips with those on external objects fashioned into household shapes, such as cups or doorknobs.

In preparation for designing the prototype, students interviewed physical therapists at Spaulding Rehabilitation Hospital in Boston who shed light on patient needs.

Pacella, a senior mechanical engineering major, praised his group’s final design. “No other device assists with opening the hand and has cognitive exercises like this,” he said. “Most commercial hand motion rehab devices don’t use sensors to measure range of motion and control of the fingers.”

Mavroidis, who has filed a provisional patent on the glove, plans to license and commercialize the rehab device, which would cost patients approximately $200. But there’s work to be done. “It still needs to become more user-friendly, stronger and thinner,” Mavroidis explained.

Pacella said programming and developing circuit boards for the prototype forced him outside of his comfort zone, which, he said, would serve him well in his first professional job.

“There’s no such thing as a job in only mechanical engineering,” Pacella said. “In the real world, you need to understand other disciplines, which you can only learn through experience.”

Ranky agreed, highlighting the value of experiential learning. “Working on a capstone project is different from solving a problem in class where there is only one solution,” he said. “Capstone is as close as you can get to the real world.”