Examining How Motor Rehabilitation Promotes Brain Reorganization Following Stroke, an MRI Study
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 12/27/2018 |
| Start Date: | July 2012 |
| End Date: | June 2020 |
Examining Mechanisms of Neuroplasticity Following Motor Rehabilitation in Stroke
Constraint-induced movement therapy (CI therapy) is a highly efficacious treatment for
residual motor disability in chronic stroke. Its effectiveness is believed to be due, at
least in part, to the therapy's ability to aid the brain in "rewiring itself." For example,
CI therapy produces increases in the amount of grey matter (the parts of the brain where
neuron cell bodies are most closely clustered) in certain areas of the human brain (Gauthier
et al., 2008). The cellular and molecular mechanisms that are responsible for this increase
in grey matter volume are not known, however. Thus, it is unclear how the therapy helps
brains "rewire" themselves. This study aims to better understand the timecourse and
cellular/molecular nature of brain changes during CI therapy. Because there is currently no
way to directly measure cellular/molecular changes in the brain noninvasively, this study
will infer what is happening on a microstructural level using new MRI techniques (three
dimensional pictures of the brain). For example, by charting the timecourse of grey matter
changes during CI therapy, and cross-comparing this to what is known about the timecourses of
different cellular/molecular processes, the investigators can gain a greater understanding of
what cellular processes may be responsible for increases in grey matter. The investigators
will gain additional information about which cellular processes are important for
rehabilitation-induced improvement by measuring larger-scale changes (e.g., amount of blood
flow through different brain areas) that accompany cellular changes. The investigators are
hopeful that by better understanding how CI therapy can change the brain, the effectiveness
of rehabilitation can be improved upon. For example, insight into the mechanisms of
rehabilitation-induced brain change may suggest particular drug targets to increase brain
plasticity. This study will help us better understand how the brain repairs itself after
injury.
residual motor disability in chronic stroke. Its effectiveness is believed to be due, at
least in part, to the therapy's ability to aid the brain in "rewiring itself." For example,
CI therapy produces increases in the amount of grey matter (the parts of the brain where
neuron cell bodies are most closely clustered) in certain areas of the human brain (Gauthier
et al., 2008). The cellular and molecular mechanisms that are responsible for this increase
in grey matter volume are not known, however. Thus, it is unclear how the therapy helps
brains "rewire" themselves. This study aims to better understand the timecourse and
cellular/molecular nature of brain changes during CI therapy. Because there is currently no
way to directly measure cellular/molecular changes in the brain noninvasively, this study
will infer what is happening on a microstructural level using new MRI techniques (three
dimensional pictures of the brain). For example, by charting the timecourse of grey matter
changes during CI therapy, and cross-comparing this to what is known about the timecourses of
different cellular/molecular processes, the investigators can gain a greater understanding of
what cellular processes may be responsible for increases in grey matter. The investigators
will gain additional information about which cellular processes are important for
rehabilitation-induced improvement by measuring larger-scale changes (e.g., amount of blood
flow through different brain areas) that accompany cellular changes. The investigators are
hopeful that by better understanding how CI therapy can change the brain, the effectiveness
of rehabilitation can be improved upon. For example, insight into the mechanisms of
rehabilitation-induced brain change may suggest particular drug targets to increase brain
plasticity. This study will help us better understand how the brain repairs itself after
injury.
Inclusion Criteria:
- Males or females 18 years of age and over
- Experienced a stroke resulting in mild to moderate hemiparesis (some residual motor
function, e.g. able to pick up a washcloth placed flat on a table) at least 6 months
prior to enrollment. Suggested active range of motion criteria for this level of
impairment include: 45° shoulder abduction and flexion, 20° elbow extension, 20° wrist
extension, and 10° extension of thumb and fingers.
- Preserved ability to comprehend and participate in basic elements of the therapy
Exclusion Criteria:
- Concurrent participation in other experimental trials for treatment of motor
dysfunction
- Having received botulinum toxin injection within the past 3 months
- Previous intensive rehabilitation in the chronic phase post-stroke
- Serious/uncontrolled medical problems (e.g., dementia, severe pain, end-stage or
degenerative diseases)
- Kidney disease as evidenced by eGFR<60
- Anemia
- Sickle cell disease
- History of kidney transplant
- Other evidence/history of renal disease
- Pregnancy
- Implanted metallic parts of implanted electronic devices, including pacemakers,
defibrillators, aneurism clip or implant medication pump that are MRI incompatible
- An implanted brain stimulator
- Permanent tattoo (e.g., eye liner) containing metallic coloring
- Claustrophobia precluding MRI
We found this trial at
1
site
Ohio State University The Ohio State University’s main Columbus campus is one of America’s largest...
Click here to add this to my saved trials
