Saturday, January 28, 2012

Stroke Survivors Are...

Athletes___
There are two populations of patients who usually recover from stroke faster than others (or, at least, have a great advantage): Athletes (incl. dance, yoga, martial arts, etc.) and musicians. 

There are three reasons for this...

Reason one: There may very well be hypertrophy of the motor portions of the brain in both athletes and musicians. We know that massed practice will reconfigure the brain, with new neurons recruited and new pathways developed. And which populations are, by definition, involved in massed practice? Athletes and musicians. 

Reason two: As anyone who is either an athlete or a musician knows, both these populations know how to train. And I don't mean just, "Yeah, I did my therapy today" kind of training. I mean the "I dream about therapy, wake up and plan my day around therapy and dedicate most of my time to therapy," kind of training. 

Reason three: Athletes and musicians are often extremely motivated to get back to their instrument or their sport.

Both athletes and musicians understand all the factors that are important to stroke rehab. They know how to practice with vigor and focus. They know the commitment of time and resources that such practice involves. And they know that if their practice routine changes, they will get different results.

Stroke survivors are true athletes. Lower level athletes playing a higher stakes game. But on the other hand, they have the most devoted fans in sport: Their loved ones. And their families and friends have every reason, both altruistic and self-serving, to coach, cajole, encourage, support and embolden their athlete toward success.

6 comments:

oc1dean said...

Okay Peter, I'll ask what should be a simple question. Or at least something I would think researchers should focus on before they prove once again that neuroplasticity works. How exactly does a neuron recruit a next door neuron to help with a task? Does it send out a cry/signal for help? Or are good samaritans running around looking for distressed neurons to help? This answer could also possibly explain why new neurons migrate to the damaged area. If we knew the answer to this the recovery of penumbra and bleed damage areas might be able to be repeatable. Heck we could send magnetic nanoparticles with the appropriate drugs to the damaged areas. If we can find the Higgs boson we can find how neurons call for help.
Dean

Peter G Levine said...

Dean,

You are, of course, one of those stroke survivors whose smarter than I am -- even after their stroke. Which, I think is totally unfair, but I have issues.

The brain is plastic. That's enough for most people, but you want to know how exactly why it is plastic. I don't know. I'll keep my eye open for this information... I may have read it and forgotten... and I'll let you know. What you probably do know is that it's not just the neurons but also the glial cells that are active during the plastic process. Prior to very recently glial cells were thought to only be supportive of neurons, not particularly active on their own. But it turns out that they to communicate with each other and are involved in the plastic process. Maybe the answer lies therein.

You say "If we knew the answer to this the recovery of a number of bleed damage areas might be able to be repeatable." Stay tuned Dean. I plan to post something on this blog that's very close to what you're suggesting...

Buh Buh Baaaaa!

oc1dean said...

And I think this research hints that brain neurons signal for help since the new neurons migrate to the damaged area.
http://www.sciencedaily.com/releases/2006/12/061223092924.htm
In mice, after a stroke was initiated in a part of the brain located far from the SVZ, the researchers, using a combination of mitotic, genetic, and viral labeling, tracked newly formed neuroblasts (immature brain cells from which mature adult neurons form) as they traveled through healthy brain tissue to the stroke area. Once there, these immature neurons wrapped themselves around the immature vascular cells that were in the process of forming new blood vessels in the damaged area. The neurons were found to arrive at the site within the first two to four weeks after the stroke.


Mice only but hey, humans should be tested.
Dean

Peter G Levine said...

Dean,

First, I misquoted you what you actually said was "If we knew the answer to this the recovery of penumbra and bleed damage areas might be able to be repeatable."

In terms of migrating neurons, that's not where the most neuroplastic change comes from. Most of the cortical rewiring happens right around the area of infarct, although we've seen brain scans (FMRI)where the rewiring is some distance from the lesion.

Mike said...

some more stuff about plasticity :

http://jslhr.asha.org/cgi/content/abstract/51/1/S225

The study is good because it shows the factors that determines recovery.They used lab rats in the study.Nothing molecular was discussed in the paper.How come no one talks about the importance of nutrition in recovery( whole food and not tabs)?

Billy Ethridge said...

See, for example, among many other credible links:Michael Merzenich, PhD (http://keck.ucsf.edu/neurograd/faculty/merzenich.html and http://www.ted.com/talks/michael_merzenich_on_the_elastic_brain.html); and the ample, rigorous and exciting work of V.S. Ramachandran MD, PhD(http://cbc.ucsd.edu/ramabio.html).

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