Deans' stroke musings: Task-specific brain reorganization in motor recovery induced by a hybrid-rehabilitation combining training with brain stimulation after stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 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:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. 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 lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, October 25, 2014

Task-specific brain reorganization in motor recovery induced by a hybrid-rehabilitation combining training with brain stimulation after stroke

Ask your doctor if this is far enough along to be copied and made into a stroke protocol. You are going to have to force your doctor to do this. I bet it will require a phone call to the hospital president before it gets accomplished.
Rant started

Yes I'm being a very bad cop but for years there has been research on rehab that looked promising but never seems to be translated into useable interventions for survivors. Either we replace all the existing stroke medical doctors with newer ones that still have a sense of desire to help or we force our doctors to actually do their job.
Rant completed, I feel better now.

If I'm wrong about this, tell me exactly where I'm wrong and we can discuss it.
http://www.sciencedirect.com/science/article/pii/S0168010214002272

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DOI: 10.1016/j.neures.2014.10.004

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Highlights

•: We developed a new hybrid-rehabilitation combining rTMS and motor training for stroke.
•: We investigated the task-specific multi-regional brain reorganization induced by it.
•: We found reduced activities in ipsilesional SMC, contralesional CMC and PMC after it.
•: The findings were shown only for the trained movements but not for the untrained ones.
•: The clinical improvements were associated with the amount of activation change.

Abstract

Recently, we have developed a new hybrid-rehabilitation combining 5 Hz repetitive transcranial magnetic stimulation and extensor motor training of the paretic upper-limb for stroke patients with flexor hypertonia. We previously showed that the extensor-specific plastic change in M1 was associated with beneficial effects of our protocol (Koganemaru et al., 2010). Here, we investigated whether extensor-specific multiregional brain reorganization occurred after the hybrid-rehabilitation using functional magnetic resonance imaging. Eleven chronic stroke patients were scanned while performing upper-limb extensor movements. Untrained flexor movements were used as a control condition. The scanning and clinical assessments were done before, immediately and 2 weeks after the hybrid-rehabilitation. As a result, during the trained extensor movements, the imaging analysis showed a significant reduction of brain activity in the ipsilesional sensorimotor cortex, the contralesional cingulate motor cortex and the contralesional premotor cortex in association with functional improvements of the paretic hands. The activation change was not found for the control condition. Our results suggested that use-dependent plasticity induced by repetitive motor training with brain stimulation might be related to task-specific multi-regional brain reorganization. It provides a key to understand why repetitive training of the target action is one of the most powerful rehabilitation strategies to help patients.