Testing the brain's ability to adapt to new tasks after stroke

Using physical therapy to help people who have become weak learn to move again is now perhaps the most widely used approach to improving the quality of life after stroke. During physical therapy sessions people are helped to learn specific types of movements with the weak arm or leg. It has been demonstrated that as patients improve one type of movement they also improve other types of movement. This ‘generalisation’ of gains in function underlies much of the practical benefits of therapy. Whilst a great deal is known about how specific skills are learned in the brain, less is known about how general improvements of this sort occur. Understanding this will increase the benefits of rehabilitation after stroke.

The researchers believe that general improvements in function occur because the physical therapy triggers normal brain mechanisms that increase brain ‘plasticity’; the ability to adapt to new tasks. They propose to test this theory by assessing plasticity in the motor system. Using functional Magnetic Resonance Imaging (fMRI) they will follow the changes in brain activity during the learning of a handgrip skill. Patients with chronic weakness after stroke will be given their usual care, or an intensive three-week period of rehabilitation. They will be observed behaviorally and with fMRI before and after this rehabilitation. The researchers predict that the brain activity changes associated with establishing a new pattern of movement will occur more rapidly, and be increased by the rehabilitation.

It is hoped that this study will provide researchers with a measure of brain plasticity that can be used to study stroke patients under other conditions. Treatments to enhance brain plasticity may then be developed.

Scientific Title: Testing for enhancement of brain plasticity by neurorehabilitation after stroke using functional magnetic resonance imaging measures of motor learning

With thanks to the Enid Linder Foundation for supporting this award.

Classification:
Imaging, Rehabilitation

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