Retraining the Brain A groundbreaking medical study from Dr. Zeiler and his colleagues of Johns Hopkins confirmed what clinicians have long suspected - we can rewire the brain so that one part takes over functions typically handled by another area - an area that was damaged by a stroke. In studies conducted with mice, the researchers first taught the mice a special way to reach for their food. The task was typically done 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. Another Potential Key to Stronger Stroke Recovery In the research, Johns Hopkins expert Steven Zeiler, M.D., Ph.D. and colleagues also found that lower levels of a protein called parvalbumin indicated that the premotor cortex had rewired after stroke. Parvalbumin marks the activity of a special class of nerve cells called inhibitory interneuronis. Low levels of parvalbumin, and therefore lowered levels of inhibitory activity, is thought to help uninjured parts of the brain take over the injured parts, say researchers. This finding suggests that reducing inhibition in certain parts of the uninjured post-stroke brain (perhaps by using different medications and/or electrical stimulation) might promote recovery. The Power of Stroke Rehab Good rehab/therapy with healthy living will help stroke recovery help prevent a second subsequent stroke from occurring. If you experience an ischemic stroke (caused by a lack of blood flow to a part of the brain), your doctor will probably recommend aspirin or another anti-clotting medication. Some other smart steps you should consider are as follows: Maintain healthy blood pressure and cholesterol levels, which differ depending on your age and medical history. You should talk these levels over with your doctor, have a reliable blood pressure monitoring machine at home which you use daily (at the same time each day and keep record of it), and be sure to take BP and cholesterol medication as prescribed. Eat a Mediterranean-type diet that is high in olive oil, legumes, cereals, fruits and vegetables and low in saturated fat, cholesterol, and sodium. You can get decent recipes for Mediterranean dishes online or purchase a complete Mediterranean cookbook. Get moderate physical exercise such as brisk walking (or jogging), cycling or swimming for 30 to 60 minutes at least four days a week. Be sure to ask your doctor if you are ready for jogging, cycling or swimming - and how far and how long. Be sure to advise him/her of all your changes in physical activity. Aim for a healthy weight, including a waist circumference of less than 31.5 inches for women and 37 for men. Again, discuss weight and size/inches with your doctor always. For complete information go to the John Hopkins website. "Limitations live only in our minds. But if we use our imaginations, our possibilities become limitless." -- Jamie Paolinetti
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