Grant: Project Grant

After stroke, many people have persistent impairments that interfere with activities of daily living and reduce quality of life. A particularly debilitating symptom is the loss or reduced ability to use the hand. Currently, the best hope to regain function is rehabilitation. However, despite advances in knowledge, rehabilitation is only partially effective. Clearly, by itself rehabilitation is not enough. Thus, many researchers are developing additional treatments to boost the effectiveness of rehabilitation. One treatment that has great promise is to deliver stimulations to the brain through the skull, for example using a magnetic field. In these treatments, the device delivers stimulation to specific regions of the brain involved in "rewiring" the stroke-damaged brain. To date, most studies have stimulated an area called the motor cortex in the undamaged hemisphere. This was shown to improve recovery in some patients. It was also shown to be ineffective or even detrimental to recovery in other patients. Clearly the stimulations should be applied to other brain areas in these patients. Several brain regions have good potential. However, we are not sure which regions are the best targets for the stimulation to help recovery. To answer this question, we need to understand better how stroke affects each area. Our objective is to study how different brain areas change the way they interact or 'talk' to each other to produce movements after stroke. This will allow us to identify which areas can become targets for stimulation treatment to improve recovery of stroke patients. This information will be critical to design new, more effective treatments that we can test in future studies with our collaborators that are experts in clinical trials using neurostimulation in stroke patients.