Tuesday, September 21, 2010

Stroke research questions

I started compiling a simple list of questions that I think stroke researchers need to address regarding stroke rehabilitation. I consider them to be easy questions with difficult answers. Without these answers we are just stumbling in the dark.

1. What is the correlation between cognitive ability before the stroke and complete recovery from the stroke deficits?
2. What amount of cognitive ability is needed after the stroke to get to complete recovery?
3. Can neurons in the brain control two different processes at the same time? ie. Can the area for toe control also be used for finger control?
4. If the previous question is false then how is it decided which functions of the brain are thrown out to neuroplastically recover damaged functions? This assumes that 100% of the brain is in use and the 10% use of the brain is a myth.
5. How many persons go insane while recovering from a stroke? This is a serious question.
6. How does brain reserve get built up again?
7. Why has no one folowed up on Brunstroms six stages of recovery to map exactly what needs to be done to get from stage to stage?
8. How much sensation is needed to fully recover motor ability?
10. What needs to be done to bring back proprioception?
11. Which therapy is best for getting a new area to start performing functions from a dead area? Passive movement, mirror-box therapy, or mental imagery?
12. How many passive movements are required to start neuroplasticity?
13. Does the laying down of new functions facilitate related functions nearby? If shoulder muscle control relocates, does that make it easier for arm and hand control to relocate nearby?
14. What is the order that recovery should work on? Should complete leg work be done before working on arm/hand issues? Or can therapy be interspersed?
15. Has the spasticity issue finally been resolved? Should spasticity be treated? From 2004-5 there were a number of researchers stating we should not treat spasticity, it was a normal protection effect of the stroke.
16. Do new neurons grow into the dead area? Where does neurogenesis lay down the new neurons?
17. Would cell homing be useful as a pointer for stem cells?
18. Which technolgy has been proven to be better, c3A peptides or NOGO receptors?
19. In 20 years when the boomers are fully into having strokes, what will you tell them about complete recovery from a stroke? They will not accept 'I don't know' for an answer.
20. How many years after a stroke is the tumor necrosis factor (TNF) is still around in the brain? In regards to the use of etanercept.
21. Is anyone researching white matter recovery vs. gray matter?

I eventually will keep going on these questions. As a lark I once said I could come up with 1000, with a little help that wouldn't be hard. Someday I will figure out how to get these to NINDS.

1 comment:

  1. Dean said:"Someday I will figure out how to get these to NINDS." Good luck on that one. My experience has been that no medical professional will listen to a demented stroke survivor, who cannot "Accept" that their life has changed.

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