scholarly journals Combining motor learning and brain stimulation to enhance post-stroke neurorehabilitation

2015 ◽  
Vol 10 (8) ◽  
pp. 1218 ◽  
Author(s):  
Yves Vandermeeren ◽  
Stéphanie Lefebvre
Author(s):  
John W. Krakauer

Rehabilitation is a form of directed training and is therefore predicated on the idea that patients respond to such training by learning. Current concepts in motor learning are reviewed. Recovery is not synonymous with re-learning and that it is important to be specific about what learning mechanism is being targeted by any given therapy. There is a unique milieu of heightened plasticity post-stroke that is responsible for reduction in impairment both through spontaneous biological recovery and increased responsiveness to training. In the chronic phase of stroke, plasticity returns to normal levels and learning for the most part only leads to task-specific compensation. Thus, new forms of intervention may have quite distinct effects depending on whether they are initiated in the sensitive period after stroke or in the chronic phase. It is to be hoped that new pharmacological and non-invasive brain stimulation approaches will allow the post-stroke sensitive period to be augmented, extended, and re-opened.


2021 ◽  
pp. 174569162199063
Author(s):  
Cecilia Heyes ◽  
Caroline Catmur

Ten years ago, Perspectives in Psychological Science published the Mirror Neuron Forum, in which authors debated the role of mirror neurons in action understanding, speech, imitation, and autism and asked whether mirror neurons are acquired through visual-motor learning. Subsequent research on these themes has made significant advances, which should encourage further, more systematic research. For action understanding, multivoxel pattern analysis, patient studies, and brain stimulation suggest that mirror-neuron brain areas contribute to low-level processing of observed actions (e.g., distinguishing types of grip) but not to high-level action interpretation (e.g., inferring actors’ intentions). In the area of speech perception, although it remains unclear whether mirror neurons play a specific, causal role in speech perception, there is compelling evidence for the involvement of the motor system in the discrimination of speech in perceptually noisy conditions. For imitation, there is strong evidence from patient, brain-stimulation, and brain-imaging studies that mirror-neuron brain areas play a causal role in copying of body movement topography. In the area of autism, studies using behavioral and neurological measures have tried and failed to find evidence supporting the “broken-mirror theory” of autism. Furthermore, research on the origin of mirror neurons has confirmed the importance of domain-general visual-motor associative learning rather than canalized visual-motor learning, or motor learning alone.


BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016566
Author(s):  
Eline C C van Lieshout ◽  
Johanna M A Visser-Meily ◽  
Sebastiaan F W Neggers ◽  
H Bart van der Worp ◽  
Rick M Dijkhuizen

IntroductionMany patients with stroke have moderate to severe long-term sensorimotor impairments, often including inability to execute movements of the affected arm or hand. Limited recovery from stroke may be partly caused by imbalanced interaction between the cerebral hemispheres, with reduced excitability of the ipsilesional motor cortex while excitability of the contralesional motor cortex is increased. Non-invasive brain stimulation with inhibitory repetitive transcranial magnetic stimulation (rTMS) of the contralesional hemisphere may aid in relieving a post-stroke interhemispheric excitability imbalance, which could improve functional recovery. There are encouraging effects of theta burst stimulation (TBS), a form of TMS, in patients with chronic stroke, but evidence on efficacy and long-term effects on arm function of contralesional TBS in patients with subacute hemiparetic stroke is lacking.Methods and analysisIn a randomised clinical trial, we will assign 60 patients with a first-ever ischaemic stroke in the previous 7–14 days and a persistent paresis of one arm to 10 sessions of real stimulation with TBS of the contralesional primary motor cortex or to sham stimulation over a period of 2 weeks. Both types of stimulation will be followed by upper limb training. A subset of patients will undergo five MRI sessions to assess post-stroke brain reorganisation. The primary outcome measure will be the upper limb function score, assessed from grasp, grip, pinch and gross movements in the action research arm test, measured at 3 months after stroke. Patients will be blinded to treatment allocation. The primary outcome at 3 months will also be assessed in a blinded fashion.Ethics and disseminationThe study has been approved by the Medical Research Ethics Committee of the University Medical Center Utrecht, The Netherlands. The results will be disseminated through (open access) peer-reviewed publications, networks of scientists, professionals and the public, and presented at conferences.Trial registration numberNTR6133


2021 ◽  
Vol 429 ◽  
pp. 118583
Author(s):  
Nina Trushkova ◽  
Olga Cochran ◽  
Natalia Ermolina ◽  
Giovanni Zelano

2013 ◽  
Vol 333 ◽  
pp. e524 ◽  
Author(s):  
E. Papuć ◽  
K. Obszańska ◽  
T. Trojanowski ◽  
Z. Stelmasiak ◽  
K. Rejdak

Sign in / Sign up

Export Citation Format

Share Document