So ask your doctor when this will be translated into a stroke protocol. And get in your doctors face until they answer. They are supposed to know more than you do. Hah!
http://link.springer.com/article/10.1007/s13311-013-0245-y
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Abstract
The last decade has
seen a growing interest in adjuvant treatments that synergistically
influence mechanisms underlying rehabilitation of paretic upper limb in
stroke. One such approach is invasive
neurostimulation of spared cortices at the periphery of a lesion.
Studies in animals have shown that during training of paretic limb,
adjuvant stimulation targeting the peri-infarct circuitry enhances
mechanisms of its reorganization, generating functional advantage.
Success of early animal studies and clinical reports, however, failed to
translate to a phase III clinical trial. As lesions in humans are
diffuse, unlike many animal models, peri-infarct circuitry may not be a
feasible, or consistent target across most. Instead, alternate
mechanisms, such as changing transcallosal inhibition between
hemispheres, or reorganization of other viable regions in motor control,
may hold greater potential. Here, we review comprehensive mechanisms of
clinical recovery and factors that govern which mechanism(s) become
operative when. We suggest novel approaches that take into account a
patient’s initial clinical–functional state, and findings from
neuroimaging and neurophysiology to guide to their most suitable
mechanism for ideal targeting. Further, we suggest new localization
schemes, and bypass strategies that indirectly target peri-lesional
circuitry, and methods that serve to counter technical and theoretical
challenge in identifying and stimulating such targets at the periphery
of infarcts in humans. Last, we describe how stimulation may modulate
mechanisms differentially across varying phases of recovery- a temporal
effect that may explain missed advantage in clinical trials and help
plan for the next stage. With information presented here, future trials
would effectively be able to target patient’s specific mechanism(s) with
invasive (or noninvasive) neurostimulation for the greatest, most
consistent benefit.
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