Computers may help patients restore movement after stroke

I'm less interested in the computer part than the idea that the undamaged half can send signals. With that we should have the ability to axon sprout  around dead areas and reconnect to the correct neurons to the rest of the body. And maybe they could then prove that neurons can multitask.
http://medicalxpress.com/news/2012-07-patients-movement.html

n patients, scientists at Washington University School of Medicine in St. Louis have shown they can detect the brain simply thinking about moving a partially or completely paralyzed hand. The half of the brain that normally thinks such thoughts and moves the hand can no longer do so because of stroke damage. Instead, the signal comes from the undamaged half of the brain. The new study suggests it may be possible to harness these signals to restore a fuller range of movement in the patient’s limbs. “We’ve known for some time that the brain can reroute or otherwise adapt its circuits to cope with an injury,” says senior author Eric Leuthardt, MD, associate professor of neurosurgery, of biomedical engineering and of neurobiology. “Now we have proof-of-principle that we can use technology to aid that process.” To demonstrate the potential to help restore movement, scientists connected brain signals detected by an electrode-studded cap to the movements of a cursor on a computer screen. In 30 minutes or less, patients learned to control the movement of the cursor with thoughts of moving their impaired hand. Researchers are now working on a motorized glove that will make the imagined movements a reality. The results are available online in The Journal of Neural Engineering. Leuthardt, who is director of Washington University’s Center for Innovation in Neuroscience and Technology, is a pioneer in the field of brain-computer interfaces, or devices that allow the brain to communicate directly with computers to restore abilities lost to injury or disease. Much of Leuthardt’s research has focused on patients with epilepsy who are undergoing surgery to remove the part of the brain where their seizures originate. He uses the electrode grids temporarily implanted on the surface of the brain to pinpoint areas where the seizures begin. With the patients’ permissions, Leuthardt also uses the implants to gather and analyze detailed information on brain activity for future use in brain-computer interfaces. This approach laid the foundations for the technique now being applied to the stroke population. In the new research, first author David Bundy, a graduate student, worked with four patients who had suffered strokes that caused extensive damage on one side of the brain. All were experiencing paralysis or significant difficulty moving the hand on the opposite side of the body. The brain signals that control movement are low-frequency signals, which makes them relatively easy to detect with electrodes on the outside of the skull. Researchers fitted patients with an electrode-studded cap connected to a computer, and asked them to perform a finger-tapping activity. Depending on a cue flashed on a screen in front of them, the patients either tapped the fingers of their unimpaired hand or imagined tapping the fingers of the impaired hand. Scientists used the cap to identify signals in healthy part of the brain that accompanied the imaginary movements. The researchers are now developing motorized braces that can be controlled by similar signals, with the goal of restoring full movement in weak or paralyzed limbs. “This is an exciting development that opens up new opportunities to help even more patients overcome limitations imposed by brain damage or degeneration,” Leuthardt says.

Read more at: http://medicalxpress.com/news/2012-07-patients-movement.html#jCp

In patients, scientists at Washington University School of Medicine in St. Louis have shown they can detect the brain simply thinking about moving a partially or completely paralyzed hand. The half of the brain that normally thinks such thoughts and moves the hand can no longer do so because of stroke damage. Instead, the signal comes from the undamaged half of the brain. The new study suggests it may be possible to harness these signals to restore a fuller range of movement in the patient’s limbs. “We’ve known for some time that the brain can reroute or otherwise adapt its circuits to cope with an injury,” says senior author Eric Leuthardt, MD, associate professor of neurosurgery, of biomedical engineering and of neurobiology. “Now we have proof-of-principle that we can use technology to aid that process.” To demonstrate the potential to help restore movement, scientists connected brain signals detected by an electrode-studded cap to the movements of a cursor on a computer screen. In 30 minutes or less, patients learned to control the movement of the cursor with thoughts of moving their impaired hand. Researchers are now working on a motorized glove that will make the imagined movements a reality. The results are available online in The Journal of Neural Engineering. Leuthardt, who is director of Washington University’s Center for Innovation in Neuroscience and Technology, is a pioneer in the field of brain-computer interfaces, or devices that allow the brain to communicate directly with computers to restore abilities lost to injury or disease. Much of Leuthardt’s research has focused on patients with epilepsy who are undergoing surgery to remove the part of the brain where their seizures originate. He uses the electrode grids temporarily implanted on the surface of the brain to pinpoint areas where the seizures begin. With the patients’ permissions, Leuthardt also uses the implants to gather and analyze detailed information on brain activity for future use in brain-computer interfaces. This approach laid the foundations for the technique now being applied to the stroke population. In the new research, first author David Bundy, a graduate student, worked with four patients who had suffered strokes that caused extensive damage on one side of the brain. All were experiencing paralysis or significant difficulty moving the hand on the opposite side of the body. The brain signals that control movement are low-frequency signals, which makes them relatively easy to detect with electrodes on the outside of the skull. Researchers fitted patients with an electrode-studded cap connected to a computer, and asked them to perform a finger-tapping activity. Depending on a cue flashed on a screen in front of them, the patients either tapped the fingers of their unimpaired hand or imagined tapping the fingers of the impaired hand. Scientists used the cap to identify signals in healthy part of the brain that accompanied the imaginary movements. The researchers are now developing motorized braces that can be controlled by similar signals, with the goal of restoring full movement in weak or paralyzed limbs. “This is an exciting development that opens up new opportunities to help even more patients overcome limitations imposed by brain damage or degeneration,” Leuthardt says.

n patients, scientists at Washington University School of Medicine in St. Louis have shown they can detect the brain simply thinking about moving a partially or completely paralyzed hand. The half of the brain that normally thinks such thoughts and moves the hand can no longer do so because of stroke damage. Instead, the signal comes from the undamaged half of the brain. The new study suggests it may be possible to harness these signals to restore a fuller range of movement in the patient’s limbs. “We’ve known for some time that the brain can reroute or otherwise adapt its circuits to cope with an injury,” says senior author Eric Leuthardt, MD, associate professor of neurosurgery, of biomedical engineering and of neurobiology. “Now we have proof-of-principle that we can use technology to aid that process.” To demonstrate the potential to help restore movement, scientists connected brain signals detected by an electrode-studded cap to the movements of a cursor on a computer screen. In 30 minutes or less, patients learned to control the movement of the cursor with thoughts of moving their impaired hand. Researchers are now working on a motorized glove that will make the imagined movements a reality. The results are available online in The Journal of Neural Engineering. Leuthardt, who is director of Washington University’s Center for Innovation in Neuroscience and Technology, is a pioneer in the field of brain-computer interfaces, or devices that allow the brain to communicate directly with computers to restore abilities lost to injury or disease. Much of Leuthardt’s research has focused on patients with epilepsy who are undergoing surgery to remove the part of the brain where their seizures originate. He uses the electrode grids temporarily implanted on the surface of the brain to pinpoint areas where the seizures begin. With the patients’ permissions, Leuthardt also uses the implants to gather and analyze detailed information on brain activity for future use in brain-computer interfaces. This approach laid the foundations for the technique now being applied to the stroke population. In the new research, first author David Bundy, a graduate student, worked with four patients who had suffered strokes that caused extensive damage on one side of the brain. All were experiencing paralysis or significant difficulty moving the hand on the opposite side of the body. The brain signals that control movement are low-frequency signals, which makes them relatively easy to detect with electrodes on the outside of the skull. Researchers fitted patients with an electrode-studded cap connected to a computer, and asked them to perform a finger-tapping activity. Depending on a cue flashed on a screen in front of them, the patients either tapped the fingers of their unimpaired hand or imagined tapping the fingers of the impaired hand. Scientists used the cap to identify signals in healthy part of the brain that accompanied the imaginary movements. The researchers are now developing motorized braces that can be controlled by similar signals, with the goal of restoring full movement in weak or paralyzed limbs. “This is an exciting development that opens up new opportunities to help even more patients overcome limitations imposed by brain damage or degeneration,” Leuthardt says.

Read more at: http://medicalxpress.com/news/2012-07-patients-movement.html#jCp

n patients, scientists at Washington University School of Medicine in St. Louis have shown they can detect the brain simply thinking about moving a partially or completely paralyzed hand. The half of the brain that normally thinks such thoughts and moves the hand can no longer do so because of stroke damage. Instead, the signal comes from the undamaged half of the brain. The new study suggests it may be possible to harness these signals to restore a fuller range of movement in the patient’s limbs. “We’ve known for some time that the brain can reroute or otherwise adapt its circuits to cope with an injury,” says senior author Eric Leuthardt, MD, associate professor of neurosurgery, of biomedical engineering and of neurobiology. “Now we have proof-of-principle that we can use technology to aid that process.” To demonstrate the potential to help restore movement, scientists connected brain signals detected by an electrode-studded cap to the movements of a cursor on a computer screen. In 30 minutes or less, patients learned to control the movement of the cursor with thoughts of moving their impaired hand. Researchers are now working on a motorized glove that will make the imagined movements a reality. The results are available online in The Journal of Neural Engineering. Leuthardt, who is director of Washington University’s Center for Innovation in Neuroscience and Technology, is a pioneer in the field of brain-computer interfaces, or devices that allow the brain to communicate directly with computers to restore abilities lost to injury or disease. Much of Leuthardt’s research has focused on patients with epilepsy who are undergoing surgery to remove the part of the brain where their seizures originate. He uses the electrode grids temporarily implanted on the surface of the brain to pinpoint areas where the seizures begin. With the patients’ permissions, Leuthardt also uses the implants to gather and analyze detailed information on brain activity for future use in brain-computer interfaces. This approach laid the foundations for the technique now being applied to the stroke population. In the new research, first author David Bundy, a graduate student, worked with four patients who had suffered strokes that caused extensive damage on one side of the brain. All were experiencing paralysis or significant difficulty moving the hand on the opposite side of the body. The brain signals that control movement are low-frequency signals, which makes them relatively easy to detect with electrodes on the outside of the skull. Researchers fitted patients with an electrode-studded cap connected to a computer, and asked them to perform a finger-tapping activity. Depending on a cue flashed on a screen in front of them, the patients either tapped the fingers of their unimpaired hand or imagined tapping the fingers of the impaired hand. Scientists used the cap to identify signals in healthy part of the brain that accompanied the imaginary movements. The researchers are now developing motorized braces that can be controlled by similar signals, with the goal of restoring full movement in weak or paralyzed limbs. “This is an exciting development that opens up new opportunities to help even more patients overcome limitations imposed by brain damage or degeneration,” Leuthardt says.

Read more at: http://medicalxpress.com/news/2012-07-patients-movement.html#jCp

n patients, scientists at Washington University School of Medicine in St. Louis have shown they can detect the brain simply thinking about moving a partially or completely paralyzed hand. The half of the brain that normally thinks such thoughts and moves the hand can no longer do so because of stroke damage. Instead, the signal comes from the undamaged half of the brain. The new study suggests it may be possible to harness these signals to restore a fuller range of movement in the patient’s limbs. “We’ve known for some time that the brain can reroute or otherwise adapt its circuits to cope with an injury,” says senior author Eric Leuthardt, MD, associate professor of neurosurgery, of biomedical engineering and of neurobiology. “Now we have proof-of-principle that we can use technology to aid that process.” To demonstrate the potential to help restore movement, scientists connected brain signals detected by an electrode-studded cap to the movements of a cursor on a computer screen. In 30 minutes or less, patients learned to control the movement of the cursor with thoughts of moving their impaired hand. Researchers are now working on a motorized glove that will make the imagined movements a reality. The results are available online in The Journal of Neural Engineering. Leuthardt, who is director of Washington University’s Center for Innovation in Neuroscience and Technology, is a pioneer in the field of brain-computer interfaces, or devices that allow the brain to communicate directly with computers to restore abilities lost to injury or disease. Much of Leuthardt’s research has focused on patients with epilepsy who are undergoing surgery to remove the part of the brain where their seizures originate. He uses the electrode grids temporarily implanted on the surface of the brain to pinpoint areas where the seizures begin. With the patients’ permissions, Leuthardt also uses the implants to gather and analyze detailed information on brain activity for future use in brain-computer interfaces. This approach laid the foundations for the technique now being applied to the stroke population. In the new research, first author David Bundy, a graduate student, worked with four patients who had suffered strokes that caused extensive damage on one side of the brain. All were experiencing paralysis or significant difficulty moving the hand on the opposite side of the body. The brain signals that control movement are low-frequency signals, which makes them relatively easy to detect with electrodes on the outside of the skull. Researchers fitted patients with an electrode-studded cap connected to a computer, and asked them to perform a finger-tapping activity. Depending on a cue flashed on a screen in front of them, the patients either tapped the fingers of their unimpaired hand or imagined tapping the fingers of the impaired hand. Scientists used the cap to identify signals in healthy part of the brain that accompanied the imaginary movements. The researchers are now developing motorized braces that can be controlled by similar signals, with the goal of restoring full movement in weak or paralyzed limbs. “This is an exciting development that opens up new opportunities to help even more patients overcome limitations imposed by brain damage or degeneration,” Leuthardt says.

Read more at: http://medicalxpress.com/news/2012-07-patients-movement.html#jCp

n patients, scientists at Washington University School of Medicine in St. Louis have shown they can detect the brain simply thinking about moving a partially or completely paralyzed hand. The half of the brain that normally thinks such thoughts and moves the hand can no longer do so because of stroke damage. Instead, the signal comes from the undamaged half of the brain. The new study suggests it may be possible to harness these signals to restore a fuller range of movement in the patient’s limbs. “We’ve known for some time that the brain can reroute or otherwise adapt its circuits to cope with an injury,” says senior author Eric Leuthardt, MD, associate professor of neurosurgery, of biomedical engineering and of neurobiology. “Now we have proof-of-principle that we can use technology to aid that process.” To demonstrate the potential to help restore movement, scientists connected brain signals detected by an electrode-studded cap to the movements of a cursor on a computer screen. In 30 minutes or less, patients learned to control the movement of the cursor with thoughts of moving their impaired hand. Researchers are now working on a motorized glove that will make the imagined movements a reality. The results are available online in The Journal of Neural Engineering. Leuthardt, who is director of Washington University’s Center for Innovation in Neuroscience and Technology, is a pioneer in the field of brain-computer interfaces, or devices that allow the brain to communicate directly with computers to restore abilities lost to injury or disease. Much of Leuthardt’s research has focused on patients with epilepsy who are undergoing surgery to remove the part of the brain where their seizures originate. He uses the electrode grids temporarily implanted on the surface of the brain to pinpoint areas where the seizures begin. With the patients’ permissions, Leuthardt also uses the implants to gather and analyze detailed information on brain activity for future use in brain-computer interfaces. This approach laid the foundations for the technique now being applied to the stroke population. In the new research, first author David Bundy, a graduate student, worked with four patients who had suffered strokes that caused extensive damage on one side of the brain. All were experiencing paralysis or significant difficulty moving the hand on the opposite side of the body. The brain signals that control movement are low-frequency signals, which makes them relatively easy to detect with electrodes on the outside of the skull. Researchers fitted patients with an electrode-studded cap connected to a computer, and asked them to perform a finger-tapping activity. Depending on a cue flashed on a screen in front of them, the patients either tapped the fingers of their unimpaired hand or imagined tapping the fingers of the impaired hand. Scientists used the cap to identify signals in healthy part of the brain that accompanied the imaginary movements. The researchers are now developing motorized braces that can be controlled by similar signals, with the goal of restoring full movement in weak or paralyzed limbs. “This is an exciting development that opens up new opportunities to help even more patients overcome limitations imposed by brain damage or degeneration,” Leuthardt says.

Read more at: http://medicalxpress.com/news/2012-07-patients-movement.html#jCp     

n patients, scientists at Washington University School of Medicine in St. Louis have shown they can detect the brain simply thinking about moving a partially or completely paralyzed hand. The half of the brain that normally thinks such thoughts and moves the hand can no longer do so because of stroke damage. Instead, the signal comes from the undamaged half of the brain. The new study suggests it may be possible to harness these signals to restore a fuller range of movement in the patient’s limbs. “We’ve known for some time that the brain can reroute or otherwise adapt its circuits to cope with an injury,” says senior author Eric Leuthardt, MD, associate professor of neurosurgery, of biomedical engineering and of neurobiology. “Now we have proof-of-principle that we can use technology to aid that process.” To demonstrate the potential to help restore movement, scientists connected brain signals detected by an electrode-studded cap to the movements of a cursor on a computer screen. In 30 minutes or less, patients learned to control the movement of the cursor with thoughts of moving their impaired hand. Researchers are now working on a motorized glove that will make the imagined movements a reality. The results are available online in The Journal of Neural Engineering. Leuthardt, who is director of Washington University’s Center for Innovation in Neuroscience and Technology, is a pioneer in the field of brain-computer interfaces, or devices that allow the brain to communicate directly with computers to restore abilities lost to injury or disease. Much of Leuthardt’s research has focused on patients with epilepsy who are undergoing surgery to remove the part of the brain where their seizures originate. He uses the electrode grids temporarily implanted on the surface of the brain to pinpoint areas where the seizures begin. With the patients’ permissions, Leuthardt also uses the implants to gather and analyze detailed information on brain activity for future use in brain-computer interfaces. This approach laid the foundations for the technique now being applied to the stroke population. In the new research, first author David Bundy, a graduate student, worked with four patients who had suffered strokes that caused extensive damage on one side of the brain. All were experiencing paralysis or significant difficulty moving the hand on the opposite side of the body. The brain signals that control movement are low-frequency signals, which makes them relatively easy to detect with electrodes on the outside of the skull. Researchers fitted patients with an electrode-studded cap connected to a computer, and asked them to perform a finger-tapping activity. Depending on a cue flashed on a screen in front of them, the patients either tapped the fingers of their unimpaired hand or imagined tapping the fingers of the impaired hand. Scientists used the cap to identify signals in healthy part of the brain that accompanied the imaginary movements. The researchers are now developing motorized braces that can be controlled by similar signals, with the goal of restoring full movement in weak or paralyzed limbs. “This is an exciting development that opens up new opportunities to help even more patients overcome limitations imposed by brain damage or degeneration,” Leuthardt says.

Read more at: http://medicalxpress.com/news/2012-07-patients-movement.html#jCp

n patients, scientists at Washington University School of Medicine in St. Louis have shown they can detect the brain simply thinking about moving a partially or completely paralyzed hand. The half of the brain that normally thinks such thoughts and moves the hand can no longer do so because of stroke damage. Instead, the signal comes from the undamaged half of the brain. The new study suggests it may be possible to harness these signals to restore a fuller range of movement in the patient’s limbs. “We’ve known for some time that the brain can reroute or otherwise adapt its circuits to cope with an injury,” says senior author Eric Leuthardt, MD, associate professor of neurosurgery, of biomedical engineering and of neurobiology. “Now we have proof-of-principle that we can use technology to aid that process.” To demonstrate the potential to help restore movement, scientists connected brain signals detected by an electrode-studded cap to the movements of a cursor on a computer screen. In 30 minutes or less, patients learned to control the movement of the cursor with thoughts of moving their impaired hand. Researchers are now working on a motorized glove that will make the imagined movements a reality. The results are available online in The Journal of Neural Engineering. Leuthardt, who is director of Washington University’s Center for Innovation in Neuroscience and Technology, is a pioneer in the field of brain-computer interfaces, or devices that allow the brain to communicate directly with computers to restore abilities lost to injury or disease. Much of Leuthardt’s research has focused on patients with epilepsy who are undergoing surgery to remove the part of the brain where their seizures originate. He uses the electrode grids temporarily implanted on the surface of the brain to pinpoint areas where the seizures begin. With the patients’ permissions, Leuthardt also uses the implants to gather and analyze detailed information on brain activity for future use in brain-computer interfaces. This approach laid the foundations for the technique now being applied to the stroke population. In the new research, first author David Bundy, a graduate student, worked with four patients who had suffered strokes that caused extensive damage on one side of the brain. All were experiencing paralysis or significant difficulty moving the hand on the opposite side of the body. The brain signals that control movement are low-frequency signals, which makes them relatively easy to detect with electrodes on the outside of the skull. Researchers fitted patients with an electrode-studded cap connected to a computer, and asked them to perform a finger-tapping activity. Depending on a cue flashed on a screen in front of them, the patients either tapped the fingers of their unimpaired hand or imagined tapping the fingers of the impaired hand. Scientists used the cap to identify signals in healthy part of the brain that accompanied the imaginary movements. The researchers are now developing motorized braces that can be controlled by similar signals, with the goal of restoring full movement in weak or paralyzed limbs. “This is an exciting development that opens up new opportunities to help even more patients overcome limitations imposed by brain damage or degeneration,” Leuthardt says.

Read more at: http://medicalxpress.com/news/2012-07-patients-movement.html#jCp

n patients, scientists at Washington University School of Medicine in St. Louis have shown they can detect the brain simply thinking about moving a partially or completely paralyzed hand. The half of the brain that normally thinks such thoughts and moves the hand can no longer do so because of stroke damage. Instead, the signal comes from the undamaged half of the brain. The new study suggests it may be possible to harness these signals to restore a fuller range of movement in the patient’s limbs. “We’ve known for some time that the brain can reroute or otherwise adapt its circuits to cope with an injury,” says senior author Eric Leuthardt, MD, associate professor of neurosurgery, of biomedical engineering and of neurobiology. “Now we have proof-of-principle that we can use technology to aid that process.” To demonstrate the potential to help restore movement, scientists connected brain signals detected by an electrode-studded cap to the movements of a cursor on a computer screen. In 30 minutes or less, patients learned to control the movement of the cursor with thoughts of moving their impaired hand. Researchers are now working on a motorized glove that will make the imagined movements a reality. The results are available online in The Journal of Neural Engineering. Leuthardt, who is director of Washington University’s Center for Innovation in Neuroscience and Technology, is a pioneer in the field of brain-computer interfaces, or devices that allow the brain to communicate directly with computers to restore abilities lost to injury or disease. Much of Leuthardt’s research has focused on patients with epilepsy who are undergoing surgery to remove the part of the brain where their seizures originate. He uses the electrode grids temporarily implanted on the surface of the brain to pinpoint areas where the seizures begin. With the patients’ permissions, Leuthardt also uses the implants to gather and analyze detailed information on brain activity for future use in brain-computer interfaces. This approach laid the foundations for the technique now being applied to the stroke population. In the new research, first author David Bundy, a graduate student, worked with four patients who had suffered strokes that caused extensive damage on one side of the brain. All were experiencing paralysis or significant difficulty moving the hand on the opposite side of the body. The brain signals that control movement are low-frequency signals, which makes them relatively easy to detect with electrodes on the outside of the skull. Researchers fitted patients with an electrode-studded cap connected to a computer, and asked them to perform a finger-tapping activity. Depending on a cue flashed on a screen in front of them, the patients either tapped the fingers of their unimpaired hand or imagined tapping the fingers of the impaired hand. Scientists used the cap to identify signals in healthy part of the brain that accompanied the imaginary movements. The researchers are now developing motorized braces that can be controlled by similar signals, with the goal of restoring full movement in weak or paralyzed limbs. “This is an exciting development that opens up new opportunities to help even more patients overcome limitations imposed by brain damage or degeneration,” Leuthardt says.

Read more at: http://medicalxpress.com/news/2012-07-patients-movement.html#jCp

Clinical Trials Start for Stroke Drug Developed by Scripps Research Institute, USC, and ZZ Biotech

Anything to prevent the neuronal cascade of death. I would hope they take PET scans on a daily basis proving that the penumbra is not converting to dead brain. 

Clinical Trials Start for Stroke Drug Developed by Scripps Research Institute, USC, and ZZ Biotech

  Clinical trials start this week for a stroke drug initially created by a team led by scientists at The Scripps Research Institute and the University of Southern California (USC), and further developed by biotech company ZZ Biotech.
The clinical trials will test the safety in humans of the experimental drug 3K3A-APC, which has been shown in animal models to reduce brain damage and improve motor skills after stroke when given in conjunction with a federally approved clot-busting therapy.
“I am incredibly excited about the potential for translating our science into a therapy that could have a significant impact on society,” said Scripps Research Institute Professor John Griffin, who collaborated on the scientific work with Professor Berislav V. Zlokovic, director of the Zilkha Neurogenetic Institute at the Keck School of Medicine of USC. “Stroke and its aftereffects are a huge problem in this country.”
Kent Pryor, chief operating officer of ZZ Biotech, said, “We are very pleased to have received approval from The Austrian Agency for Health and Food Safety (AGES) to initiate our first human study with 3K3A-APC. Our extensive preclinical studies into the neuroprotective effects of 3K3A-APC suggest that it is a promising candidate for the treatment of ischemic stroke.”
Fourth-Leading Cause of Death
Stroke, which occurs when blood flow to a part of the brain stops, is the fourth-leading cause of death and the leading cause of adult disability in the United States. A stroke occurs when blood flow in the brain is interrupted, cutting off part of the brain from oxygen. Some brain damage happens immediately, but even when blood flow is restored, brain cells continue dying for hours or days.
According to the American Stroke Association, the Food and Drug Administration-approved tPA (tissue plasminogen activator) is the best treatment for stroke caused by a blocked artery, but to be effective, it must be administered within three hours after symptoms start. If given outside that three-hour window, tPA has shown serious side effects in animal and human brains, including bleeding and breakdown of the brain's protective barrier.
Generally, according to the American Stroke Association, only three to five percent of those who suffer a stroke reach the hospital and satisfy relevant criteria in time to be considered for tPA treatment.
A New Approach
When Griffin’s hematology lab and Zlokovic’s neuroscience lab began collaborating more than a dozen years ago, activated protein C (APC) was known to stop the growth of blood clots and reduce inflammation, and was being tested for the treatment of adult severe sepsis.
By 2003, their collaborative work pointed to a previously unsuspected ability of APC to directly prevent programmed cell death in brain, which had emerged as a key to reducing the effects of stroke. The team found that APC dramatically decreased the cellular signals that convince brain cells to kill themselves after a stroke and boosted the cellular signals that persuade the cells to survive.
However, APC’s natural blood-thinning properties posed a potential problem to using APC as a treatment for stroke, possibly inducing bleeding in the brain. In response to this challenge, the Griffin lab (including Scripps Research scientists Laurent Mosnier and Andrew Gale) produced an engineered version of APC.
“The protein normally is an anticoagulant,” Griffin explained. “We separated out the beneficial effects of the protein acting on cells from this anticoagulant activity. This was done by protein engineering of the 3K3-APC variant to lose most of its anticoagulant activity while retaining its direct actions on cell signaling.”
Promising Data
Further work from the team on the engineered 3K3A-APC lent support to the decision to proceed with clinical trials. Large-scale production of this biologic drug, 3K3A-APC, was accomplished by ZZ Biotech with the guidance of Griffin and Thomas Davis, who is a distinguished professor of pharmacology at the University of Arizona.
The journal Stroke published a paper by Zlokovic, Griffin, and colleagues online ahead of print on July 17, 2012 (doi:10.1161/strokeaha.112.658997), showing the results of giving the federally approved stroke treatment tPA—alone and in combination with 3K3A-APC—to mice and rats four hours after onset of ischemic stroke. The team also gave 3K3A-APC for three consecutive days after stroke and measured the amount of brain damage, bleeding, and motor ability of the rodents up to seven days afterward.
The researchers found that, under those conditions, tPA therapy alone caused bleeding in the brain and did not reduce brain damage or improve motor ability when compared to the control. The combination of tPA and 3K3A-APC, however, reduced brain damage by more than half, eliminated tPA-induced bleeding, and significantly improved motor ability.
“We have developed something that not only counteracts the bleeding, but also reduces brain damage and significantly improves behavior after stroke,” said Zlokovic. “I feel very strongly that this approach will extend the therapeutic window for tPA."
The Next Step
The stage is now set for ZZ Biotech, founded by Zlokovic with USC benefactor Selim Zilkha, to launch the first clinical trials in humans for 3K3A-APC under the supervision of a leading stroke trialist, Professor Patrick Lyden, chair of the Department of Neurology at Cedars-Sinai Medical Center, Los Angeles.
The new Phase 1 study is a randomized, double-blind, placebo-controlled, single-center trial that will investigate the safety and pharmacokinetics of single and multiple ascending doses of 3K3A-APC in healthy adult volunteers. Approximately 62 eligible adult subjects will be assigned sequentially to 1 of 10 cohorts, at successively higher single doses, followed by successively higher multiple doses. Results of the study are anticipated in the first quarter of 2013.
“We are excited by the prospect of one day putting 3K3A-APC in doctors’ hands to help reduce the tremendous suffering caused by stroke,” said Joseph Romano, chief executive officer of ZZ Biotech.
About The Scripps Research Institute
The Scripps Research Institute is one of the world's largest independent, not-for-profit organizations focusing on research in the biomedical sciences. Over the past decades, Scripps Research has developed a lengthy track record of major contributions to science and health, including laying the foundation for new treatments for cancer, rheumatoid arthritis, hemophilia, and other diseases. The institute employs about 3,000 people on its campuses in La Jolla, CA, and Jupiter, FL, where its renowned scientists—including three Nobel laureates—work toward their next discoveries. The institute's graduate program, which awards Ph.D. degrees in biology and chemistry, ranks among the top ten of its kind in the nation. For more information, see www.scripps.edu.
ZZ Biotech, LLC
ZZ Biotech is a company headquartered in Houston, TX with a mission to develop innovative biological treatments for the aging and damaged brain, including those affected by stroke and other neurodegenerative disorders. ZZ Biotech is developing a genetically engineered variant of recombinant human wild-type activated protein C (APC), named 3K3A-APC, that has reduced anticoagulant activity, but preserved cell-protective and anti-inflammatory activities compared to APC. ZZ Biotech is studying the safety and pharmacokinetics of 3K3A-APC in healthy human volunteers in an ongoing Phase 1 clinical study.

Hormone Shots Aid Cognition in Older Adults

So who is going to research if something like this would help the 'brain fog' most survivors experience?
 http://www.medpagetoday.com/Neurology/GeneralNeurology/34076
2 paragraphs here:

The benefit was driven by significantly better executive function and a trend toward better verbal memory, although visual memory was not changed, the group reported online in Archives of Neurology.
GHRH stimulates release of growth hormone from the pituitary, in a pulsatile fashion, which in turn causes the release of insulin-like growth factor 1 from the liver, the researchers noted.

University Hospitals Case Medical Center to Study Stem Cell Therapy for Stroke Treatment

Hey its phase II. Not really useful for us  but progress.
http://www.ourmidland.com/prweb/article_155305c4-d5a1-5e2b-9783-f818dfd816c0.html
A new national study looking at the safety and effectiveness of medication developed from adult stem cells for the treatment of ischemic stroke has opened at University Hospitals (UH) Case Medical Center. The Phase 2 study will use a cell therapy product called MultiStem® developed by the Cleveland-based biotechnology company Athersys. Ischemic stroke is caused by blockage in an artery in or to the brain, that impedes blood flow, and that can result in serious disability or even death.
MultiStem is a proprietary medication made from a patented class of early adult stem cells called Multipotent Adult Progenitor Cells or MAPCs that are obtained from the bone marrow. Hundreds of thousands to millions of doses can be made from the bone marrow cells of one donor. The cells do not come from the patient, so can be made in advance, stored in the hospital and be used off the shelf.
Cathy Sila, M.D., principal investigator of the study, Director of the Stroke and Cerebrovascular Center at UH Case Medical Center, and Professor of Neurology at Case Western Reserve University, said that the objectives of the study are to determine the highest well-tolerated and safest single dose of MultiStem in patients with ischemic stroke and to determine the efficacy of MultiStem on functional outcome in ischemic stroke patients.
“Current therapy for stroke is unfortunately very limited. There is only one drug, tPA, that is approved for use in patients with acute ischemic stroke, and tPA needs to be administered within hours of the onset of the stroke,” said Dr. Sila. “Despite public education and the development of Stroke Centers, only about 4 percent of all ischemic stroke patients presenting to the hospital within 24 hours of their symptoms are eligible for tPA therapy. We need to develop new drugs and biologic treatments to effectively treat ischemic stroke and the damage resulting from the stroke in a wider time window so more patients can be eligible for treatment.”
“Unlike conventional drugs, we believe that MultiStem therapy provides benefit in multiple ways when administered after an acute ischemic stroke,” said Dr. Robert W. Mays, Head of Neuroscience at Athersys. “From our preclinical work, MultiStem cells appear to reduce the local inflammatory response and protect neurons in the brain, while modulating the body’s general immune response and inflammation which leads to additional damage to the brain in the days immediately following the stroke. This is an entirely new concept for how cell therapies may provide benefit following CNS injury, and we are very excited by the potential of MultiStem therapy to treat stroke,” said Dr. Mays.
“We’re trying to improve the functional outcome after a stroke,” said Dr. Sila. If MultiStem therapy ultimately proves to be effective when given at 24-36 hours after the stroke, it could mean that the majority of stroke victims would be eligible for treatment.”
The national study will involve approximately 25 sites with the goal of enrolling 140 patients. It will be double-blind (meaning both the patient and the doctors evaluating the patients won’t know which arm of the study the patient is in), randomized, placebo-controlled. The study is funded by Athersys.
Athersys has advanced four MultiStem programs to clinical stage, including for the treatment of acute myocardial infarction, ischemic stroke, inflammatory bowel disease (partnered with Pfizer Inc.), and to reduce the incidence of severe graft vs. host disease following hematopoietic stem cell transplant.
A video with Dr. Sila and the first UH research participant in the MultiStem trial is available at: http://www.youtube.com/watch?v=bRRTRa7ZEyY&feature=plcp

Use of Zinc as a Treatment for Traumatic Brain Injury in the Rat Effects on Cognitive and Behavioral Outcomes

No self-medication.
http://nnr.sagepub.com/content/26/7/907.abstract?etoc

Abstract

Background. While treatments for the behavioral deficits associated with traumatic brain injury (TBI) are currently limited, animal models suggest that zinc supplementation may increase resilience to TBI. Objective. This work tests the hypothesis that zinc supplementation after TBI can be used as treatment to improve behavioral outcomes such as anxiety, depression, and learning and memory. Methods. TBI was induced by controlled cortical impact to the medial frontal cortex. After TBI, rats were fed either a zinc adequate (ZA, 30 ppm) or zinc supplemented (ZS, 180 ppm) diet. Additional rats in each dietary group (ZA or ZS) were given a single intraperitoneal (ip) injection of zinc (30 mg/kg) 1 hour following injury. Results. Brain injury resulted in significant increases in anxiety-like and depression-like behaviors as well as impairments in learning and memory. None of the zinc treatments (dietary or ip zinc) improved TBI-induced anxiety. The 2-bottle saccharin preference test for anhedonia revealed that dietary ZS also did not improve depression-like behaviors. However, dietary ZS combined with an early ip zinc injection significantly reduced anhedonia (P < .001). Dietary supplementation after injury, but not zinc injection, significantly improved (P < .05) cognitive behavior as measured by the time spent finding the hidden platform in the Morris water maze test compared with injured rats fed a ZA diet. Conclusions. These data suggest that zinc supplementation may be an effective treatment option for improving behavioral deficits such as cognitive impairment and depression following TBI.

Kinematic Analysis of Motor Recovery With Human Adult Bone Marrow–Derived Somatic Cell Therapy in a Rat Model of Stroke

More on stem cells, but in rats.
http://nnr.sagepub.com/content/26/7/898.abstract?etoc

Abstract

Background. The extent to which pharmaceutical and behavioral therapies following central nervous system injury may either deter or encourage the development of compensatory movement patterns is a topic of considerable interest in neurorehabilitation. However, functional outcome measures alone are relatively insensitive to compensatory changes in movement patterns per se. Objective. This study used both functional outcome measures and kinematic analysis of forelimb movements to examine the effects of human adult bone marrow–derived somatic cells (hABM-SCs) on motor recovery in a rat model of stroke. Methods. Adult male Long–Evans black-hooded rats (n = 12) were trained in a forelimb reaching task and then underwent surgical middle cerebral artery occlusion, producing a stroke that impaired the trained paw. One week poststroke, animals were randomly assigned to either a hABM-SC injection or control injection group. Reaching behaviors were then compared at baseline and at 10 weeks poststroke. Results. Both groups improved their outcome scores during the 10-week recovery period. However, the hABM-SC group recovered significantly more function than controls in terms of the number of pellets retrieved. Furthermore, the control group appeared to improve their functional performance by using compensatory strategies that involved an increased number of trajectory adjustments, whereas the hABM-SC group’s kinematics more closely resembled prestroke movement patterns. Conclusions. This study demonstrates that kinematic measures established in stroke research on humans are also sensitive to performance differences prestroke versus poststroke in the rat model, reinforcing the utility of this method to evaluate treatments that may ultimately translate to patient populations.

Association of Activity Changes in the Primary Sensory Cortex With Successful Motor Rehabilitation of the Hand Following Stroke

Anything with successful and hand in the title is worth demanding that your doctor apply this to your rehab. Shades of the book;
Sensory Re-Education of the Hand after Stroke by Yekutiel Margaret in 2001
http://nnr.sagepub.com/content/26/7/881.abstract?etoc

Abstract

Background. Previous studies demonstrated a posterior shift of activation toward the primary sensory cortex (S1) following stroke; however, any relationship between this posterior shift and clinical outcome measures for the affected hand function were unclear. Objective. The authors investigated the possible role of S1 in motor recovery. Methods. Assuming that previous studies examined inhomogeneous groups of patients, the authors selected participants with chronic stroke who had moderate hand paresis, normal sensory examination and somatosensory-evoked potentials, and no lesion within the S1, thalamus, or brain stem. Constraint-induced movement therapy (CIMT) was used to train the impaired hand. To relate fMRI (functional MRI) activation changes from baseline to post-CIMT, a correlation analysis was performed with changes of the Wolf Motor Function Test (WMFT) as a test for the hand function. Results. A close relationship was found between increases in hand function and peak changes in activation within the ipsilesional S1. With a better outcome, greater increases in activation within the S1 were evident (P < .03; r = 0.73). Conclusion. In selected patients, the sensory network influences training-induced motor gains. This predictive knowledge of plasticity when applying CIMT may suggest strategies to enhance the effect of therapy, such as the addition of electrical stimulation to enhance S1 excitability.

A Perfusion fMRI Study of the Neural Correlates of Sustained-Attention and Working-Memory Deficits in Chronic Traumatic Brain Injury

We need something like this for strokes  to be able to tell whether the capillaries have properly opened up - pericytes. And to assure that there is enough blood flow for neurogenesis.
http://nnr.sagepub.com/content/26/7/870.abstract?etoc

Abstract

Background. Given that traumatic brain injury (TBI) results in chronic alteration of baseline cerebral perfusion, a perfusion functional MRI (fMRI) method that dissociates resting- and task-related cerebral blood flow (CBF) changes can be useful in noninvasively investigating the neural correlates of cognitive dysfunction and recovery in TBI. Objective. The authors used continuous arterial spin-labeled (ASL) perfusion fMRI to characterize CBF at rest and during sustained-attention and working-memory tasks. Methods. A total of 18 to 21 individuals with moderate to severe TBI and 14 to 18 demographically matched healthy controls completed 3 continuous 6-minute perfusion fMRI scans (resting, visual sustained attention, and 2-back working memory). Results. For both tasks, TBI participants showed worse behavioral performance than controls. Voxelwise neuroimaging analysis of the 2-back task found that group differences in task-induced CBF changes were localized to bilateral superior occipital cortices and the left superior temporal cortex. Whereas controls deactivated these areas during task performance, TBI participants tended to activate these same areas. These regions were among those found to be disproportionately hypoperfused at rest after TBI. For both tasks, the control and TBI groups showed different patterns of correlation between performance and task-related CBF changes. Conclusions. ASL perfusion fMRI demonstrated differences between individuals with TBI and healthy controls in resting perfusion and in task-evoked CBF changes as well as different patterns of performance-activation correlation. These results are consistent with the notion that sensory/attentional modulation deficits contribute to higher cognitive dysfunction in TBI.

Differential Effects of Power Training Versus Functional Task Practice on Compensation and Restoration of Arm Function After Stroke

Have your therapist explain what this means and how they will apply it to your rehab. Or would you rather wait 30 years until it gets to a textbook?
Do it NOW!!
http://nnr.sagepub.com/content/26/7/842.abstract?etoc

Abstract

Background. Improved upper-extremity (UE) movement with stroke rehabilitation may involve restoration of more normal or development of compensatory movement patterns. Objective. The authors investigated the differential effects of functional task practice (FTP) and dynamic resistance training (POWER) on clinical function and reaching kinematics in an effort to distinguish between mechanisms of gains. Methods. A total of 14 hemiparetic individuals were randomly assigned to 10 weeks of either FTP or POWER and then crossed over to 10 weeks of the alternate treatment. Treatment order A was FTP followed by POWER, whereas treatment order B was POWER followed by FTP. Evaluation before and after each treatment block included a battery of clinical evaluations and kinematics of paretic UE functional reach to grasp. Results. Both FTP and POWER improved movement accuracy, as revealed by a shift toward normal, including fewer submovements and reduced reach-path ratio. However, active range of motion revealed differential treatment effects. Shoulder flexion and elbow extension decreased with FTP and were associated with increased trunk displacement. In contrast, shoulder flexion and elbow extension excursion increased with POWER and were associated with significantly reduced trunk displacement. Treatment order B (POWER followed by FTP) revealed greater overall improvements. Conclusion. FTP increases compensatory movement patterns to improve UE function. POWER leads to more normal movement patterns. POWER prior to FTP may enhance the benefits of repetitive task practice.

Tracking Motor Improvement at the Subtask Level During Robot-Aided Neurorehabilitation of Stroke Patients

At least this may start moving us away from the insistence of task-specific training. 30 years from now. 

Tracking Motor Improvement at the Subtask Level During Robot-Aided Neurorehabilitation of Stroke Patients

Abstract

Background. Robot-aided neurorehabilitation can provide intensive, repetitious training to improve upper-limb function after stroke. To be more effective, motor therapy ought to be progressive and continuously challenge the patient’s ability. Current robotic systems have limited customization capability and require a physiotherapist to assess progress and adapt therapy accordingly. Objective. The authors aimed to track motor improvement during robot-assistive training and test a tool to more automatically adjust training. Methods. A total of 18 participants with chronic stroke were trained using a multicomponent reaching task assisted by a shoulder–elbow robotic assist. The time course of motor gains was assessed for each subtask of the practiced exercise. A statistical algorithm was then tested on simulated data to validate its ability to track improvement and subsequently applied to the recorded data to determine its performance compared with a therapist. Results. Patients’ recovery of motor function exhibited a time course dependent on the particular component of the executed task, suggesting that differential training on a subtask level is needed to continuously challenge the neuromuscular system and boost recovery. The proposed algorithm was tested on simulated data and was proven to track overall patient’s progress during rehabilitation. Conclusions. Tuning of the training program at the subtask level may accelerate the process of motor relearning. The algorithm proposed to adjust task difficulty opens new possibilities to automatically customize robotic-assistive training.

Botulinum Toxin Injection for Hypertonicity of the Upper Extremity Within 12 Weeks After Stroke

Read  the last line. With that how are we going to get botox use approved for stroke spasticity? I know, its needed for contracture prevention.
http://nnr.sagepub.com/content/26/7/812.abstract?etoc

Abstract

Background. Botulinum neurotoxin type A (BoNT-A) reduces upper-extremity poststroke spasticity when given 6 or more months after stroke. Effects on functional use of the arm and hand are less apparent. Objective. To determine the effect and safety of very early use of BoNT-A for patients with upper-limb spasticity. Methods. The Asia Botulinum Toxin-A Clinical Trial Designed for Early Post-stroke Spasticity (ABCDE-S; NCT00234546) was a multicenter, randomized, placebo-controlled trial conducted in patients recruited within 2 -12 weeks of first-ever stroke. Participants with a Modified Ashworth Scale (MAS) score of 1+ or above received BoNT-A (Dysport) 500 U or placebo to one or more wrist and elbow mover muscles, plus unstructured rehabilitation. The primary outcome was the MAS score in the most affected joint 4 weeks after first injection. Follow-up was 24 weeks. Results. A total of 163 patients were enrolled and assigned to placebo (n = 83) or BoNT-A (n = 80). Mean time since stroke was about 7 weeks. At 4 weeks postinjection, BoNT-A significantly improved MAS scores. Treatment effect-size estimates increased with higher baseline MAS scores from 0.45 (Q1) to 0.70 (Q3). MAS scores for all secondary end points improved with BoNT-A versus placebo at all time points (P < .0001, all visits). The Functional Motor Assessment Scale did not reveal clinically significant differences. No group differences in adverse events were found. Interpretation. BoNT-A 500 U can provide a sustained reduction in poststroke upper-limb spasticity when combined with rehabilitation in Asian patients who have mild-to-moderate hypertonicity and voluntary movement, within 2 -12 weeks of stroke. Functional use of the arm and hand was not affected.

Using Neuroimaging and Neuromodulation to Study Changes in Brain Functioning with Therapy

At least they are using objective measurement changes to see what therapy works. Every stroke researcher should be following this.
 https://www.thieme-connect.com/ejournals/abstract/10.1055/s-0032-1320038

Abstract

This article reviews the concepts underlying functional neuroimaging and its use to study brain function change as a result of recovery and neurorehabilitation for speech, voice, and swallowing. The role of neurovascular coupling for quantifying brain function change in response to behavioral demands is explained. The types of changes in brain function that are measured and how they should be interpreted are addressed for the study of brain function abnormalities in developmental and acquired speech, voice, and swallowing disorders. One challenge is to separate changes in brain function due to recovery from those that are secondary to the development of compensatory skills during therapy. The advantages of functional magnetic resonance imaging and functional near-infrared spectroscopy are compared. The use of transcranial magnetic stimulation for the study of brain function is reviewed. In addition, more recent methods for the modulation of brain function using transcranial magnetic and electrical stimulation over the cortex are examined. These technologies can be used by clinical investigators to gain better understanding of normal brain function and for learning how abnormalities in brain function might be addressed. Both are likely to lead to new therapeutic approaches to neurorehabilitation of speech, voice, and swallowing disorders.

Transcranial brain stimulation after stroke

I couldn't tell from the abstract what phase of rehab, acute or chronic, it was testing. But when I tried to get into  a research study  on this they required some movement. So that would mean that they were stimulating the penumbra and thus if your infarct was large enough to kill an area of control this style of rehab wouldn't help with those areas. Don't self magnetize.
http://www.ncbi.nlm.nih.gov/pubmed/22854873
Full article in German so ask your doctor to get and translate it for your stroke protocol if appropiate.

Abstract

Stroke is the leading cause of disability in adults. In Germany an estimated 1.5 million stroke survivors have to cope with persisting sensorimotor or cognitive deficits and effective therapies are scarce.

Abstract

Stroke is the leading cause of disability in adults. In Germany an estimated 1.5 million stroke survivors have to cope with persisting sensorimotor or cognitive deficits and effective therapies are scarce. The idea of using non-invasive brain stimulation to treat neuropsychiatric diseases was already born more than 2,000 years ago (Scribonius largus, 43-48 AD). However, only the development of modern non-invasive brain stimulation methods, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) has made it possible to evaluate these ideas. The therapeutic value of these non-invasive brain stimulation methods is currently under study for several neuropsychiatric diseases, mostly in a proof-of-principle fashion. In this article the focus will be on non-invasive brain stimulation to enhance functional regeneration after stroke.

. However, only the development of modern non-invasive brain stimulation methods, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) has made it possible to evaluate these ideas. The therapeutic value of these non-invasive brain stimulation methods is currently under study for several neuropsychiatric diseases, mostly in a proof-of-principle fashion. In this article the focus will be on non-invasive brain stimulation to enhance functional regeneration after stroke.

Homeopathy is as effective as fluoxetine in depression

Don't substitute homeopathy for real anti-depressants. See this for uses:
Anti-depressants have some proof of efficacy in helping stroke rehab .
http://oc1dean.blogspot.com/2011/10/stroke-rehabilitation-treatment.html
 Or here:
http://oc1dean.blogspot.com/2012/05/poststroke-depression.html

The supposed homeopathy help below, you will notice no abstract, big red flag.
http://onlinelibrary.wiley.com/doi/10.1111/j.2042-7166.2012.01163_5.x/full
 The wikipedia definition here: notice the quackery reference
http://en.wikipedia.org/wiki/Homeopathy

Or if you would rather read

Proposed mechanisms for homeopathy are physically impossible

But  in the final context ask your regular medical doctor, not a homeopath for answers.

An apologist here;

Is There Really Any Scientific Evidence That Homeopathy Works?

Dyslexia Studies Catch Neuroplasticity at Work

We know it works in stroke also but I don't think I've seen actual scan studies.  We need to see these types of studies for the hard neuroplasticity of dead brain recovery.  From the Dana Foundation.
http://www.dana.org/news/brainwork/detail.aspx?id=13662

10 Terrific iPad Apps for Toddlers

Some of these may be useful for us, except maybe for the potty training one. Although I could have used that after drinking large quantities of caffeine. Ask your doctor/therapist which ones they recommend.
http://mashable.com/2012/08/03/ipad-apps-toddlers/

APP-titude: Apps for Brain Injury Rehab

Just in case you don't get cognitive training help from your doctor. 10 different apps are covered.
http://www.asha.org/Publications/leader/2012/120703/APP-titude--Apps-for-Brain-Injury-Rehab.htm

Post-insult valproic acid-regulated microRNAs: potential targets for cerebral ischemia

In simpler terms another hyperacute possibility. 

Post-insult valproic acid-regulated microRNAs: potential targets for cerebral ischemia

Abstract: Stroke is a devastating brain injury that is a leading cause of adult disability with limited treatment options.
Using a rat model of middle cerebral artery occlusion (MCAO) to induce cerebral ischemia, we profiled microRNAs

(miRNAs), small non-protein coding RNAs, in the ischemic cortex. Many miRNAs were confirmed by qPCR to be robustly upregulated 24 hours following MCAO surgery including miR-155, miR-297a, miR-466f, miR-466h, and miR-1224.
In addition, we treated MCAO rats with valproic acid (VPA), a mood stabilizer and histone deacetylase inhibitor. This post-insult treatment was shown to improve neurological deficits and motor performance following MCAO. To provide mechanistic insight into the potential targets and pathways that may underlie these benefits, we profiled miRNAs regulated following this VPA treatment. Two promising post-insult VPA-regulated candidates were miR-331 and miR-885-3p. miR-331 was also regulated by VPA pre-treatment in rat cortical neuronal cultures subjected to oxygenglucose deprivation, an in vitro ischemic model. The predicted targets of these miRNAs analyzed by Ingenuity Pathway Analysis (IPA) identified networks involved in hematological system development, cell death, and nervous system development. These predicted networks were further filtered using IPA and showed significant associations with neurological diseases including movement disorders, neurodegenerative disorders, damage to cerebral cortex, and seizure disorders among others. Collectively, these data support common disease mechanisms that may be under miRNA control and provide exciting directions for further investigations aimed at elucidating the miRNA mechanisms and targets that may yield new therapies for neurological disorders.

Relationship Between Body Mass Index and Rehabilitation Outcomes in Chronic Stroke

Another excuse for not setting aggressive recovery goals. Don't be fat and have a stroke.

http://journals.lww.com/ajpmr/Abstract/publishahead/Relationship_Between_Body_Mass_Index_and.99534.aspx

Abstract

Objective: The aim of this study was to evaluate the relationship between body mass index (BMI) and change in motor impairment and functional mobility after a gait rehabilitation intervention in chronic stroke subjects.

Design: Correlation and linear regression analyses of pretreatment and end-of-treatment Fugl-Meyer scores and modified Emory Functional Ambulation Profile scores from hemiparetic subjects (n = 108, >3 mos post stroke) who participated in a randomized controlled trial comparing two 12-wk ambulation training treatments were generated.

Results: A series of linear regression models that controlled for age, sex, stroke type, interval post-stroke, and training device found the change in the Fugl-Meyer score to be significantly negatively associated with pretreatment BMI ([beta] = -0.207, P = 0.036) and the change in the "up and go" modified Emory Functional Ambulation Profile score to be significantly positively associated with BMI ([beta] = 0.216, P = 0.03). Changes in modified Emory Functional Ambulation Profile scores in floor, carpet, obstacles, or stair climbing were not significantly associated with BMI.

Conclusions: Chronic stroke subjects with a higher BMI were less likely to demonstrate improvement in motor impairment and up and go functional mobility performance in response to ambulation training, irrespective of treatment intervention. Stroke rehabilitation clinicians should consider BMI when formulating rehabilitation goals. Further studies are necessary to determine whether obesity is a predictor of longer-term post-stroke motor and functional recovery.

Warfarin Management International Normalized Ratio Self-Testing and Warfarin Self-Dosing

So it seems self-testing is now possible.
http://circ.ahajournals.org/content/126/5/e52.short

Until recently, most patients taking warfarin (brand name Coumadin) had to visit a laboratory and/or clinic every few weeks for an international normalized ratio (INR) blood test and adjustment of their warfarin dose. It is now possible for a patient to measure his/her INR (self-testing) with a finger-stick drop of blood with use of a small, portable, battery-powered device. Some self-testing patients adjust their dose of warfarin (self-dosing) based on a set of instructions. Even more recently, online systems have been developed to facilitate and improve self-testing and self-dosing. Patients who use self-testing have described it as life changing. A video on the ease and benefits of self-testing by a physician-patient named Dr Michael Schwartz can be viewed on ClotCare at www.clotcare.org/inrselftestingvideo.aspx.

Does Self-Testing Offer Benefits Beyond Ease and Convenience?

Yes. The additional benefits are why Medicare and other insurance companies started paying for self-testing for most patients in March 2008. To understand the other potential benefits, however, one needs some background information. Warfarin is used to prevent blood clots that cause strokes, heart attacks, or other life-threatening conditions. If the dose of warfarin is too small, the INR will be low, and a patient may get a blood clot. If the dose is too large, the INR will be high, and a patient may develop a bleeding problem. In most cases, an INR between 2 and 3 indicates that the warfarin dose is about right. In one large study,¹ the risk of stroke caused by a blood clot increased 3 to 4 times when the …

The right treatment is necessary to overcome a stroke

I wish I knew who was feeding this reporter this information because that person seems to know more than anyone else in the world.
http://www.whptv.com/news/local/story/The-right-treatment-is-necessary-to-overcome-a/nmS02wzwBEWt17rF8tG9tQ.cspx
a stroke can be detrimental to your health and can have lasting affects if you don't get the right treatment.  So what is the right treatment?

Study suggests strength of brain’s neural pathways a key factor in intelligence

This leads to 2 questions;
1.  Do those with better pathways recover from stroke more easily?
2. If so, how do you increase these pathways to promote better recovery?
 You'll have to read this Stanford School of Medicine article at the link.
Do you know someone from Stanford Medicine?, ask them these 2 simple questions.
 http://scopeblog.stanford.edu/2012/08/02/study-suggests-strength-of-brains-neural-pathways-a-key-factor-in-intelligence/

European research consortium plans to improve stroke rehabilitation

But they haven't asked me anything yet. Chipping away at the edges in your own silo is not going to help enough for the millions needing help every year. A comprehensive plan attacking every aspect of stroke is needed. Who is going to be the bold visionary that changes the landscape?
http://www.alphagalileo.org/ViewItem.aspx?ItemId=122700&CultureCode=en
Researchers at the University of Luxembourg, along with their international partners, want to develop an easy-to-use, self-motivating tool that stroke patients can use in their rehabilitation process.  The 4.4 million euro project is funded by the European Commission Seventh Framework Programme.
“Millions of people live with the consequences of stroke. We plan to significantly improve the monitoring and support of patients at home to maximize their recovery from cognitive impairments and to restore  cognitive functions such as memory, attention and the ability to concentrate”, says Professor Claus Vögele, who is leading the University of Luxembourg team of 7 international partners, including biologists, psychologists, neurologists, as well as industry.
Working together as part of the so-called CONTRAST project, they are developing an easy to use headset with neurofeedback electrodes, which aims to measure and increase the use of certain areas of the brain with brain-training exercises that can improve long-term cognitive performance and mental health well-being.
Prof. Vögele, whose brother suffered from a stroke, has a strong personal motivation to conduct research in helping stroke patients regain basic cognitive functions that are often lost following a stroke. “I saw a lot of missed opportunities in his rehabilitation process.  With our partners in CONTRAST, we can develop new rehabilitation tools that will help close the gap between acute patient care, rehabilitation, and outpatient care”, he explains.
In Luxembourg, the CONTRAST project is conducted by Prof. Vögele, Dr. Simone Witzmann and Cristina Campillo of the “Integrative Research Unit Social and Individual Development” (INSIDE), Faculty of Language, Literature, Humanities, Arts and Education, at the University of Luxembourg. In cooperation with the National Center for Functional Re-education and Rehabilitation, Luxembourg, (Rehazenter, Kirchberg), the researchers are looking forward to working to improve the rehabilitation process in Luxembourg’s stroke population.
 
The project itself here:
http://www.contrast-project.eu/

Different style of AFO

The bluerocker was mentioned in a stroke forum except for the $1000 cost.  Talk to your therapist on whether it might be an option. I won't because I needed the traditional one to stop foot rolling and this one doesn't look like it can handle that problem. But I've stopped wearing mine after consulting with myself.  But what the hell do I know, that's what you are paying your doctor and therapists for, to tell you the best way to recover, so ask them.
http://www.allardint.com/pdf/YTB_AInt09.pdf

Study Compares Therapist-Based and Robot-Assisted Bilateral Arm Training After Stroke

Work with your PT to come up with a home program. I would love to see exactly what this means.
http://www.ptproductsonline.com/news/2012-08-02_01.asp
Bilateral arm training (BAT) has been widely studied, however, the comparative effects of therapist-based BAT (TBAT) and robot-assisted BAT (RBAT) are unknown. Researchers in Taiwan performed a study to compare the efficacy of TBAT, RBAT, and a control treatment (CT) on motor control, functional performance, and quality of life after a chronic stroke. The results were published in the August 2012 issue of Physical Therapy.
Ching-yi Wu, ScD, OTR, from the department of occupational therapy and graduate institute of behavioral sciences at Chang Gung University, Taoyuan, Taiwan, led the study of 42 patients with an average age of 54.49 years and an average length of 17.62 months since the onset of stroke. The patients were randomly assigned to TBAT, RBAT, and CT groups, with each group receiving treatment for 90 minutes to 105 minutes per session. There were five sessions, held on weekdays for 4 weeks. Outcome measures for the study included kinematic analyses, the Fugl-Meyer Assessment (FMA), the Motor Activity Log, and the Stroke Impact Scale (SIS).
According to the results, large and significant effects were found in the kinematic variables, the distal part of upper-limb motor impairment, and certain aspects of quality of life in favor of TBAT or RBAT. The researchers found that the TBAT group demonstrated significantly better temporal efficiency and smoothness, straighter trunk motion, and less trunk compensation. The RBAT group reportedly had increased shoulder flexion. Furthermore, on the FMA, the TBAT group showed higher distal part scores than the CT group and, on the SIS, the RBAT group had better strength subscale, physical function domain, and total scores than the CT group.
The researchers conclude that, compared with CT, TBAT and RBAT exhibited differential effects on outcome measures. TBAT may improve temporal efficiency, smoothness, trunk control, and motor impairment of the distal upper limb, while RBAT may improve shoulder flexion and quality of life. The authors note that this study recruited patients with mild spasticity and without cognitive impairments.

Saebo Launches New Biofeedback/Stim Device

I know this is commercialization but this is interesting.
 http://e2.ma/message/xosne/h0m6cc
This line is interesting.

What is the Patent Pending Reciprocal EMG

Triggered Stimulation (RETS) Program?

The RETS (Reciprocal EMG Triggered Stimulation) program is ideal for clients with increased tone that have difficulty relaxing the spastic muscles.  The biofeedback stimulation program involves both the agonist and antagonist muscles and is triggered upon relaxation of a muscle instead of activation.

Stimulation is triggered to the desired muscle group (i.e., finger extensors, elbow extensors, etc.) once the client relaxes the opposing hypertonic muscle group (i.e., spastic finger flexors, elbow flexors, etc).  Therefore, the emphasis is placed on relaxing the hypertonic muscles in order for stimulation to be triggered to the opposing weakened muscle group.

Is it even possible to willfully relax the tonic muscles? I'd love to see the research on that.

The Neurobiology of Brain Injury

Another great article from the Dana Foundation. Your doctor should be able to recite everything  in it.
http://dana.org/news/cerebrum/detail.aspx?id=39280
A few lines from it.
Importantly, the brain can limit the spread of damage by forming a glial scar that seals off the damaged region.
 Brain injury leads to increased neural plasticity in the spared regions. This allows the neurons in these regions to take over the sensory or motor functions that had been performed by the damaged areas.

Repairing the Injured Brain Why Proper Rehabilitation Is Essential to Recovering Function

A great article explaining what you need to know  about your challenges to recovery. Your doctor should have given you this information.
From the Dana Foundation.
http://dana.org/news/cerebrum/detail.aspx?id=39258
A couple of lines from it. Read it all.
Since most people with brain injury live a nearly normal life span (the overall average is seven years decreased life expectancy).
Amphetamine administration in concert with therapy may enhance and accelerate the rate and extent of recovery of motor function.
Therapies that are conducted one or two times a week are unlikely to be of sufficient dose to facilitate neurological re-modeling. It has been shown that in order for neurons to learn a specific motor function, that motor function must be repeated hundreds of times.
Treatment of people with acquired brain injury is highly specialized and poorly understood by practitioners in the general medical and allied health fields. 

Brain sponge: Stroke treatment may extend time to prevent brain damage

A catchy title, you might even be able to remember to ask for this in the ER. Think Sponge Bob Square Pants.

http://scopeblog.stanford.edu/2011/07/25/brain-sponge-stroke-treatment-may-extend-time-to-prevent-brain-damage/
A new study in mice reports that admistering pharmacological doses of a “sponge-like” molecule that occurs naturally in the human body may stave off brain damage from stroke. 
One of the study’s two senior co-authors, neuroimmunologist Larry Steinman, MD, has published several articles in the past few years on the substance’s anti-inflammatory properties and possible therapeutic benefits in indications ranging from multiple sclerosis (his specialty) to heart attack.
Strokes – there’s a new one every 40 seconds in North America alone – are caused by a sudden drop in the flow of blood to the brain resulting from a clot or, less often, bleeding. Here are the grim statistics:

The largest single cause of severe neurological disability and the third-leading cause of death in the United States, stroke accounts for an estimated $74 billion annually in related costs, including treatment and additional assistance for the three of every four stroke patients whose ability to perform the activities of daily life is impaired. One of every three stroke patients is under the age of 65. In all, there are 5.4 million stroke survivors in the United States and 15 million worldwide.

The only currently approved treatment, tissue plasminogen activator or tPA, is not only costly, but must be given within 4.5 hours of the incident to be effective. That’s already tough, given the initial denial that often prevents those experiencing a stroke from immediately getting help. Further complicating the logistics is the fact that before administering tPA to a patient, doctors have to first run a brain scan to make sure the patient’s stroke was caused by a clot, not by bleeding. (If it’s the latter, tPA, which works by dissolving clots, would make it even worse.)
The substance tested in the study, alpha-B-crystallin, is produced in healthy tissues as well as in the brain in response to a stroke – but, according to neurosurgeon Gary Steinberg, MD, PhD, the study’s other senior co-author, not in sufficient amounts to fully quench the inflammatory mayhem that follows. Indeed, much of the damage caused by stroke is due not to the initial blockage of blood flow to affected brain areas, but to the ensuing storm of inflammatory activity brought about by a scream of molecular sirens, an ensuing police riot of trigger-happy immune cells squirting brain-cell-breaking oxidants.
Alpha-B-crystalline seems to act like a sponge, soaking up all these crazed inflammatory hotheads, shrinking the ultimate size of the stroke lesion, and apparently reducing the resulting behavioral deficits even when given 12 hours after the stroke. At least in mice. (Stay tuned.)

Down-regulation of parkin protein in transient focal cerebral ischemia: A link between stroke and degenerative disease?

So maybe I had a valid question when I asked my doctor if I was likely to get Parkinsons. Of course he just blindly dismissed the question. Since this was 4 years prior to my stroke he should have known of this study. My ischemia was 90 minutes duration.
http://www.pnas.org/content/99/23/15042.short

Abstract

Ubiquitylated protein aggregates are characteristic features of neurodegenerative disorders that are also found in acute pathological states of the brain such as stroke. Many of the proteins connected to neurodegenerative diseases play a role in the ubiquitin-proteasomal pathway. Mutation of one of these proteins, the E3 ubiquitin ligase parkin, is the cause of autosomal recessive juvenile Parkinson's disease. Here we show that transient focal cerebral ischemia of 1-h duration induces marked depletion of parkin protein levels, to 60%, 36%, 33%, and 25% of controls after 1, 3, 6, and 24 h of reperfusion, but that ischemia does not cause lower protein levels of E2 ubiquitin-conjugating enzymes Ubc6, Ubc7, or Ubc9.
After 3 h of reperfusion, when parkin protein levels were already reduced to less than 40% of control, ATP levels were almost completely recovered from ischemia and we did not observe DNA fragmentation, suggesting that parkin depletion preceded development of neuronal cell death. Up-regulation of the expression of parkin has been shown to protect cells from injury induced by endoplasmic reticulum (ER) dysfunction, and this form of cellular stress is also triggered by transient cerebral ischemia. However, in contrast to observations in neuroblastoma cells, we saw no up-regulation of parkin expression in primary neuronal cell cultures after induction of ER dysfunction. Our data thus suggest that ischemia-induced depletion of parkin protein may contribute to the pathological process resulting in cell injury by increasing the sensitivity of neurons to ER dysfunction and the aggregation of ubiquitylated proteins during the reperfusion period.




And maybe a fix for this particular problem.

Protein may help neurons fix themselves in Parkinson’s patients

Building muscles while playing computer games

Yeah for down under.  Ask your PT if the wearable ankle robot can replace your AFO. I wish they would show what the devices look like.
http://www.scoop.co.nz/stories/GE1208/S00006/building-muscles-while-playing-computer-games.htm
Researchers from The University of Auckland have developed advanced rehabilitation devices to help stroke patients strengthen their muscles while at the same time playing computer games.
“The main goal is not to play the game but to stimulate the patient’s interest so while they are playing the computer game they gain muscle strength, says Professor Shane Xie.
Professor Xie, and other researchers from the University, have developed two types of wearable exoskeleton devices for stroke patients, one for gait rehabilitation and the other for upper limb rehabilitation. They have also developed a wearable ankle robot to aid in the rehabilitation of ankle sprains.
The devices have been tested on people with and without disabilities, and the next stage is to run more clinical trials involving stroke patients.
Professor Xie, will talk about the rehabilitation devices and his other research during his inaugural professorial lecture, Biomechatronic technology for the future of healthcare, at the Faculty of Engineering’s Technologies for Health research event tomorrow night.

Professor Peter Xu, Chair in Mechatronics, from the Department of Mechanical Engineering will also give his inaugural lecture Mechatronics for Innovative Smart Medical Devices at the event.
Professor Xie, from the Department of Mechanical Engineering, is the University’s first ever Chair in Biomechatronics. Biomechatronics is the interdisciplinary study of biology, mechanics, electronics, software and control. It focuses on the interactivity of biological organs with electromechanical devices and systems.
Professor Xie is head of the University’s Medical and Rehabilitation Robotics Research Group where the rehabilitation devices and robot technology is being developed.
“Our research is targeted at people whose strength and coordination has been affected by amputation, stroke, cerebral palsy, or aging. We believe appropriate mechanical assistance can not only restore function but enhance performance beyond typical human limits, he says.
Professor Xie says the rehabilitation devices improve people’s mobility and their quality of life.
“Even 20 years after a stroke a person can gain mobility through rehabilitation exercises,” he says.
Professor Xie’s other research areas include surgical robotics for brain and orthopaedic surgery.
The Faculty of Engineering has a strong focus on developing devices and technologies to improve healthcare in the community. The Technologies for Health research event will be hosted by The Dean of Engineering Professor Michael Davies.
Before and after the inaugural lectures there will be an exhibition of Technologies for Health research, including information on vocal tract modelling, nanoindentation of biological material and mechanobiology of musculoskeletal tissues.
Technologies for Health - Inaugural lectures and showcase of new technologies
The University of Auckland’s Faculty of Engineering
Date/time: Thursday 2 August 2012, 5.30 -7pm (showcase 5.30-5.45pm and 7 to 7.30pm)
Venue: Lecture Theatre 1.439, Building 401, Faculty of Engineering, 20 Symonds Street, Auckland.

Effects of Inpatient Rehabilitation on Functional Recovery of Stroke Patients: a Comparison of Chronic Stroke Patients with and without Cognitive Impairment

So the next question to ask is. What level of cognitive ability is needed to recover 50%, 75%, 100%? And follow that for years.
https://www.jstage.jst.go.jp/article/jpts/24/3/24_245/_article
[Purpose] The purpose of this study was to investigate the effects of inpatient rehabilitation on functional recovery of chronic stroke patients with cognitive impairment. [Subjects] This study recruited 63 patients, who underwent a rehabilitation program after stroke between May, 2008 and May, 2010. Patients were divided according to the Mini Mental State Examination (MMSE) total scores into a cognitive impairment group (MMSE<21) and a non-cognitive impairment group (MMSE≥22). All patients were evaluated ADL performance, balance and walking ability at admission and discharge. [Results] The scores of Modified Barthel Index (MBI), Berg Balance Scale (BBS), and walking ability of chronic stroke patients with cognitive impairment improved significantly after 3 months of the rehabilitation program. [Conclusion] These results suggest that inpatient rehabilitation improves the functional recovery of chronic stroke patients with cognitive impairment.

Effects of occupational therapy and neurofeedback on recovery of the motor function in stroke patients (A Single-System Design)

I can't even guess what language this is in. So ask your occupational therapist to translate this for you. Its a full 8 page pdf. Maybe Iranian.

زمینه و هدف : نواقص حرکتی شامل همی پارزي ، عدم هماهنگی و اسپاستیسیتی از رایج ترین آسیب هاي بعد از سکته مغزي هستند. بیشتر بیماران در
http://journals.tums.ac.ir/upload_files/pdf/_/21477.pdf

Cross-talk between neural stem cells and immune cells: the key to better brain repair?

Sounds good but you'll have to ask your doctor to translate the full article for you and apply it to your therapy protocol. You do have a therapy protocol? Don't you?
http://www.nature.com/neuro/journal/v15/n8/abs/nn.3163.html

Abstract

Systemic or intracerebral delivery of neural stem and progenitor cells (NSPCs) and activation of endogenous NSPCs hold much promise as potential treatments for diseases in the human CNS. Recent studies have shed new light on the interaction between the NSPCs and cells belonging to the innate and adaptive arms of the immune system. According to these studies, the immune cells can be both beneficial and detrimental for cell genesis from grafted and endogenous NSPCs in the CNS, and the NSPCs exert their beneficial effects not only by cell replacement but also by immunomodulation and trophic support. The cross-talk between immune cells and NSPCs and their progeny seems to determine both the efficacy of endogenous regenerative responses and the mechanism of action as well as the fate and functional integration of grafted NSPCs. Better understanding of the dialog between NSPCs and innate and adaptive immune cells is crucial for further development of effective strategies for CNS repair.