Deans' stroke musings: Priming sensorimotor cortex to enhance task-specific training after subcortical 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.

Sunday, May 17, 2020

Priming sensorimotor cortex to enhance task-specific training after subcortical stroke

Useless, just investigation and 'may', NOT CREATION OF PROTOCOLS.

Priming sensorimotor cortex to enhance task-specific training after subcortical stroke

Suzanne J. Ackerleya,c, Cathy M. Stinearb,c, P. Alan Barberc,d, Winston D. Byblowa,c,⇑ aMovement Neuroscience Laboratory, Department of Sport and Exercise Science, The University of Auckland, Auckland, New Zealand bClinical Neuroscience Laboratory, Department of Medicine, The University of Auckland, Auckland, New Zealand cCentre for Brain Research, The University of Auckland, Auckland, New Zealand dNeurology Department, Auckland City Hospital, Auckland, New Zealand

Article history: Accepted 23 November 2013 Available online xxxx
Keywords: Sensorimotor integration Short latency afferent inhibition Stroke rehabilitation Theta burst stimulation Transcranial magnetic stimulation
highlights
The effects of Theta Burst Stimulation (TBS)-primed dexterity training on sensorimotor integration, corticomotor excitability, sensation and grip-lift kinetics were examined in chronic subcortical stroke patients. Intermittent TBS (iTBS) of ipsilesional primary motor cortex(M1) modulated corticomotor excitability and increased M1 receptiveness to sensory input. Priming ipsilesional M1 with iTBS prior to upper limb therapy may facilitate sensorimotor integration and serve as a useful adjunct to improve the quality of sensorimotor training during rehabilitation after subcortical stroke.

abstract

Objective:

This double-blind sham-controlled crossover study investigated the interactions between primary sensory and motor cortex after stroke and their response to Theta Burst Stimulation (TBS).

Methods:

Thirteen chronic subcortical stroke patients with upper limb impairment performed standardised dexterity training primed with ipsilesional M1 intermittent TBS (iTBSiM1), contralesional M1 continuous TBS (cTBScM1) or sham TBS. The effects on sensorimotor integration, corticomotor excitability, sensation and grip-lift kinetics were examined.

Results:

After iTBSiM1,improvements in paretic grip-lift performance were accompanied by animmediate facilitation of ipsilesional M1 excitability and a subsequent increase in ipsilesional short latency afferent inhibition (SAI) during training. Precision grip-lift performance improved after cTBScM1 and training, alongside increased ipsilesional M1 excitability with no effect on ipsilesional SAI. There were no effects on sensory performance.

Conclusion:

Primary motor cortex iTBS not only modulates M1 corticospinal excitability but also increases M1 receptiveness to sensory input.

Signiﬁcance:

Priming with iTBSiM1 may enhance ipsilesional sensorimotor integration and facilitate better quality sensorimotor training after subcortical stroke. 2013 Published by Elsevier Ireland Ltd. on behalf of International Federation of Clinical Neurophysiology.