These John Hopkins people are missing the real
problems in stroke. This is a prime example of failure in leadership from a supposed expert. Just 'happy talk' not realism.
http://m.hopkinsmedicine.org/health/healthy_aging/healthy_body/new-hope-for-stroke-recovery#.Vor2YojNQOM.twitter
While more people are surviving strokes, many still face long-term
disability. But Johns Hopkins research finds promising ways to retrain
the brain and regain independence. Here’s what experts have learned
about the power of physical rehab.
The good news about
stroke:
More people are surviving the initial stroke. The bad news about
stroke: More people are surviving the initial stroke with disabilities
which might have been minimized if they had received the kind of early,
intensive physical rehabilitation that researchers find can improve
function and reduce long-term disability. In fact, as many as 60 percent
are left with diminished use of an arm or leg.
“When we speak about recovery we’re really talking about how the
nervous system adapts to the brain missing a part of functioning
tissue,” explains Johns Hopkins expert
(Hah!) Steven Zeiler, M.D., Ph.D.
“
We’ve done all we could in the acute period,(Completely and totally wrong you solve the neuronal cascade of death. You're making an invalid assumption that new interventions won't be found. Be a leader, tackle the difficult problems), but the damage is done
and it’s irreversible.
(What about neurogenesis?)” The question then becomes, “How do you get the
remainder of the nervous system to adapt?” In other words, can we get
other parts of the brain to pick up the slack? Turns out that yes, we
can.
Retraining the Brain
A groundbreaking Johns Hopkins study from Zeiler and his colleagues
confirmed what clinicians have long suspected—we can rewire the brain so
that one part takes over functions typically handled by another, now
damaged, area.
In studies conducted with mice, the researchers first taught the mice a
special way to reach for food. The task is typically directed by a part
of the brain called the
primary motor cortex, which is
involved in physical coordination. Then they gave the mice mild strokes
that damaged this motor cortex. As expected, the mice could no longer
perform the reaching task with their pre-stroke level of precision. Two
days after the stroke, however, researchers began retraining the mice
and, after a week, the mice performed the task just as well as before
the stroke.
The damaged part of the brain hadn’t recovered, says Zeiler. Instead, another part of the brain called the
medial premotor cortex took over. To show that, researchers gave the mice strokes in
that part of the brain and saw the reaching ability again disappear. But, once again, the mice relearned the task as yet
another part of the brain stepped in to handle the job of the medial premotor cortex.
In a similar study, the researchers found that the earlier retraining
started, the better. “If you retrained the mice after a one-day delay
they got better, but after a seven-day delay they didn’t improve,”
Zeiler says.
Johns Hopkins’ Kata Project, a collaboration between neuroscientists,
engineers, animal experts, artists and entertainment industry experts,
has designed an immersive experience for post-stroke patients who will
try to “swim” as a virtual dolphin named Bandit. Upcoming clinical
trials will determine if this unique experience helps patients recover
motor function faster than the current conventional treatment of
repetitive exercises.
The Power of Stroke Rehab
The take-home message of the research, says Zeiler, is that “early and
intense” rehabilitation—even while still hospitalized—is critical in
stroke recovery. Unfortunately, that’s not always the standard practice,
he says. “As a medical community we need to push for immediate and
intense change in rehabilitation.”
