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, September 21, 2019

Stimulation targeting higher motor areas in stroke rehabilitation: A proof-of-concept, randomized, double-blinded placebo- controlled study of effectiveness and underlying mechanisms HHS Public Access

My conclusion is that since you didn't even write up a tentative stroke protocol everything here is useless for survivors.  Didn't even tell us why anodal tDCS was used.

Stimulation targeting higher motor areas in stroke rehabilitation: A proof-of-concept, randomized, double-blinded placebo- controlled study of effectiveness and underlying mechanisms HHS Public Access

David A. Cunninghama,b, Nicole Varnerina, Andre Machadoc, Corin Bonnetta, Daniel Janinia, Sarah Roellea, Kelsey Potter-Bakera, Vishwanath Sankarasubramaniana, Xiaofeng Wangd, Guang Yuee, and Ela B. Plowa,c,f,*aDepartment of Biomedical Engineering, Lerner Research Inst., Cleveland Clinic, Cleveland, OH, USAb School of Biomedical Sciences, Kent State University, Kent, OH, USAc Center for Neurological Restoration, Neurosurgery, Neurological Inst., Cleveland Clinic, Cleveland, OH, USA d Department of Quantitative Health Sciences, Cleveland Clinic, OH, USA e Human Performance & Engineering Laboratory, Kessler Foundation Research Center, West Orange, NJ, USA f Department of Physical Medicine & Rehab, Neurological Inst., Cleveland Clinic, Cleveland, OH,
Abstract Purpose
To demonstrate, in a proof-of-concept study, whether potentiating ipsilesional higher motor areas (premotor cortex and supplementary motor area) augments and accelerates recovery associated with constraint induced movement.
Methods
 In a randomized, double-blinded pilot clinical study, 12 patients with chronic stroke were assigned to receive anodal transcranial direct current stimulation (tDCS) ( n  = 6) or sham ( n  = 6) to the ipsilesional higher motor areas during constraint-induced movement therapy. We assessed functional and neurophysiologic outcomes before and after 5 weeks of therapy.
Results
Only patients receiving tDCS demonstrated gains in function and dexterity. Gains were accompanied by an increase in excitability of the contralesional rather than the ipsilesional hemisphere. Conclusions— Our proof-of-concept study provides early evidence that stimulating higher motor areas can help recruit the contralesional hemisphere in an adaptive role in cases of greater ipsilesional injury. Whether this early evidence of promise translates to remarkable gains in functional recovery compared to existing approaches of stimulation remains to be confirmed in
  large-scale clinical studies that can reasonably dissociate stimulation of higher motor areas from that of the traditional primary motor cortices




 * Corresponding author: Ela B. Plow, PhD, PT, Assistant Staff, Biomedical Engineering, 9500 Euclid Ave, ND20, Cleveland Clinic, Cleveland, 44195 OH, USA. Tel.: +1 216 445 4589; Fax: +1 216 444 9198; plowe2@ccf.org. HHS Public Access Author manuscript

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