The research, being presented at Neuroscience 2015, the annual meeting of the Society for Neuroscience, is the first to focus on the transient changes that transcranial magnetic stimulation (TMS) can affect in patients with severely disabling post-stroke arm impairment.
“Little research has looked at this severely impaired population — most is aimed at improving relatively mild movement impairments — and, as a consequence, no validated treatment is available to help those with the most severe disabilities,” says Rachael Harrington, a fourth-year PhD student in the Interdisciplinary Program in Neuroscience at Georgetown University Medical Center (GUMC) who will present the study.
Harrington is working with principal investigator Michelle L. Harris-Love, PT, PhD, a member of the Center for Brain Plasticity and Repair, a program based at Georgetown University and MedStar National Rehabilitation Network (MedStar NRH). Harris-Love directs the Mechanisms of Therapeutic Rehabilitation (MOTR) Laboratory at MedStar NRH.
The proof-of-principle study shows a role for control of affected arm movement in the side of the brain not affected by the stroke, she says. Modulating function of this area using TMS altered motor function in a way that was not observed in patients with more mild arm impairment. This suggests that the targeted area may have a special role in recovery for more severely impaired patients.
Follow-up studies will assess whether repeated stimulation of the unaffected side of the brain can help to “teach” it to control the impaired arm, Harrington says. “Stimulating this area repeatedly may force the brain to use this latent area — neurons that fire together wire together.”
“These findings offer promise that these patients may be able to gain function, independence and a better quality of life,” she says. Harrington adds that between 30 and 40 percent of the 600,000 strokes that occur annually result in chronic upper arm impairment.
TMS, currently approved by the FDA only for drug-resistant depression, is being tested as a treatment for a wide variety of brain disorders.
The study is being funded by the National Institutes of Health (NIH) (K01 HD060886) and the American Heart Association (AHA). Harrington’s doctoral studies were funded by the NIH (T32 NS041231), Medstar NRH and the AHA.
About the Center for Brain Plasticity and RecoveryThe Center for Brain Plasticity and Recovery, a Georgetown University and MedStar National Rehabilitation Network collaboration, focuses on the study of biological processes underlying the brain’s ability to learn, develop, and recover from injury. Through interdisciplinary laboratory and clinical research, the Center for Brain Plasticity and Recovery aims to find ways to restore cognitive, sensory, and motor function caused by neurological damage and disease.
About Georgetown University Medical CenterGeorgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC’s mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization (BGRO), which accounts for the majority of externally funded research at GUMC including a Clinical Translation and Science Award from the National Institutes of Health.
About MedStar National Rehabilitation NetworkConsistently ranked by physicians as one of the top rehabilitation networks in America in U.S. News & World Report, the MedStar NRH Network offers inpatient, day treatment and outpatient services in Washington, D.C., Maryland and Northern Virginia. The Network provides comprehensive programs specifically designed for the rehabilitation of individuals recovering from neurologic and orthopaedic conditions, including sports injuries. The hospital is a private, not-for-profit facility located in Northwest Washington, D.C. and treats patients age 6 and older. For more information, visit www.MedStarNRH.org.
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