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:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Wednesday, February 21, 2018

Pre-therapy neural state of bilateral motor and premotor cortices predicts therapy gain after subcortical stroke: A pilot study

You fucking bastards are once again wasting time and money on predictions rather than solving all the problems in stroke. Your mentors and senior researchers need to be keel-hauled. If solving stroke is too hard for you take up macrame and let better people into the field. 
https://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J77787&phrase=no&rec=135758&article_source=Rehab&international=0&international_language=&international_location=
American Journal of Physical Medicine and Rehabilitation , Volume 97(1) , Pgs. 23-33.

NARIC Accession Number: J77787.  What's this?
ISSN: 0894-9115.
Author(s): Cirstea, Carmen M.; Lee, Phil; Craciunas, Sorin C.; Choi, In-Young; Burris, Joseph E.; Nudo, Randolph J..
Publication Year: 2018.
Number of Pages: 12.
Abstract: Study investigated whether neural state of spared motor and premotor cortices captured before therapy predicts therapy-related motor gains in chronic subcortical stroke. Ten stroke survivors with chronic, moderate upper-limb impairment underwent proton magnetic resonance spectroscopy, magnetic resonance imaging, clinical, and kinematics assessments before a 4-week impairment-oriented training. Clinical/kinematics assessments were repeated after therapy, and motor gain was defined as positive values of clinical upper-limb/elbow motion changes and negative values of trunk motion changes. Candidate predictors were N-acetylaspartate-neuronal marker, glutamate-glutamine-indicator of glutamatergic neurotransmission, and myo-inositol-glial marker, measured bilaterally within the upper limb territory in motor and premotor (premotor cortex, supplementary motor area) cortices. Traditional predictors (age, stroke length, pre-therapy upper-limb clinical impairment, infarct volume) were also investigated. Results indicated poor motor gain was associated with lower glutamate-glutamine levels in ipsilesional primary motor cortex and premotor cortex, lower N-acetylaspartate in ipsilesional premotor cortex, higher glutamate-glutamine in contralesional primary motor cortex, and lower glutamate-glutamine in contralesional supplementary motor area. These predictors outperformed myo-inositol metrics and traditional predictors. The findings suggest that glutamatergic state of bilateral motor and premotor cortices and neuronal state of ipsilesional premotor cortex may be important for predicting motor outcome in the context of a restorative therapy.
Descriptor Terms: BIOCHEMISTRY, BIOENGINEERING, BODY MOVEMENT, BRAIN, IMAGING, LIMBS, MOTOR SKILLS, OUTCOMES, STROKE, THERAPEUTIC TRAINING.


Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Cirstea, Carmen M., Lee, Phil, Craciunas, Sorin C., Choi, In-Young, Burris, Joseph E., Nudo, Randolph J.. (2018). Pre-therapy neural state of bilateral motor and premotor cortices predicts therapy gain after subcortical stroke: A pilot study.  American Journal of Physical Medicine and Rehabilitation , 97(1), Pgs. 23-33. Retrieved 2/21/2018, from REHABDATA database.

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