Grant: CIHR Fellowship

Stroke is the leading cause of adult disability in Canada. Impaired arm and hand function after stroke is linked to changes in the way different parts of our brain work together. These changes in brain activity impair processes that help with recovery of arm and hand function. Restoring brain activity to the pattern seen before the stroke can maximize recovery. We can alter patterns of brain activity using brain stimulation. This non-invasive, painless approach temporarily turns down the activity in overactive parts of the brain before we practice a task, allowing other regions to have greater involvement. This approach has shown benefit - pairing brain stimulation with practice of movements using the arm and hand after stroke can result in improvements in function. However, the response has been varied. We think the reason for variable responses to brain stimulation is because patterns of brain activity after stroke are highly individualized. To improve effectiveness, we will use individual data to determine the target (i.e., brain area) for brain stimulation, an approach that has yet to be taken. The proposed research will 1) determine targets for brain stimulation after stroke by examining patterns of brain activity on an individual basis, and 2) investigative individualized brain stimulation paired with practice of movements using the arm and hand to aid recovery after stroke. By using this novel approach to identify targets for brain stimulation paired with movement practice on an individual basis after stroke, this work represents a critical step in improving interventions that pair brain stimulation with motor practice for stroke recovery. Further, this work will show that improvements in hand and arm function are maximized when targets are tailored to the individual. Ultimately, this research will advance rehabilitation and recovery after stroke, leading to improved daily function and better quality of life for Canadians living with stroke.