Grant: Operating Grant

After a stroke the excitability of the brain decreases on the stroke side and increases on the opposite, non-stroke side. These changes make use of the stroke-affected arm difficult and slow recovery. Rehabilitation exercises that increase arm use after stroke help increase brain excitability, but the net effect of this approach is low. New therapies are needed that restore more equal levels of brain excitability between the two sides. Brain stimulation is a noninvasive way to affect activity the excitability of brain cells. Pairing brain stimulation with exercises that require patients to learn new movements may help the brain to learn. Using stimulation that reduces activity in the side opposite to the stroke can increase activity on the stroke-affected side, through connections between the two brain hemispheres. The purpose of this study is to test if brain stimulation on the side opposite to the stroke, paired with arm movement exercises, can help patients learn new arm movements and improve arm function. In this study people with stroke will receive brain stimulation over two different areas on the side of the brain opposite to the stroke: 1) those areas responsible for movement and 2) those responsible for sensation. These experiments will test both the short and long term effects of brain stimulation on patients' learning and arm function and will allow us to identify which area of the brain best improves learning and arm function. These experiments have the potential to improve the effectiveness of rehabilitation after stroke. The proposed study is among the first to test stimulation over the side of the brain opposite to the stroke damage and at multiple sites. This unique approach may help stimulate the development of new methods for stroke rehabilitation.