Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, November 10, 2015

Treatment-Induced Neuroplasticity Following Intensive Speech Therapy and a Home Practice Program in Fifteen Cases of Chronic Aphasia

This is most interesting because it is for chronic. So your therapist should be using this to prevent your aphasia from becoming chronic. An updated stroke protocol should be expected from your therapist.
http://www.frontiersin.org/10.3389/conf.fpsyg.2015.65.00024/event_abstract
  • 1 University of Massachusetts Amherst, USA
  • 2 Neurometrika, USA
Introduction Evidence suggests that intensive aphasia therapy can take advantage of the brain’s potential to ‘overcome learned non-use’ (Pulvermuller & Berthier, 2008). Many patients have shown significant language improvements, but few studies have examined the neuroplastic changes accompanying such improvements over time. The current study examined changes in behavior and fMRI activity in 15 aphasic individuals who were tested pre-/post-treatment and six months after use of a tablet-based home practice program. Methods Twenty participants with chronic moderate-to-severe post-stroke aphasia completed a 2-week intensive treatment program. The primary outcome measure was confrontation naming on sets of treated (TR) or untreated (UNTR) drawings of common objects (Snodgrass & Vanderwart, 1980) and picturable actions (Masterson & Druks, 1998). Participant characteristics included a range of time post-onset (MPO=6-142; mean=26.8); auditory comprehension (BDAE-3 percentile: 6th-83rd; mean=47th); naming (BNT % correct=0-78; mean=44.4); sentence repetition (BDAE-3 percentile: 5th-80th; mean=39th). Following treatment, participants autonomously practiced retrieving words for half TR and half UNTR actions and objects with an iPad-based home practice (HP) program for six months. Functional MRI data were acquired on a 3T system at three time-points from 15 MR-compatible participants who completed the HP program (S1:pre-treatment; S2:post-treatment; S3:6mos post-HP). Participants overtly named blocks of TR, matched UNTR, and consistently correct (CORR) pictures of objects and actions in S1 and S2. Pictures were blocked by practice condition, i.e., practiced (PR) or unpracticed (UNPR) in S3. SPM8 was used for pre-processing (realign, co-register with 3D MPRAGE, segment, indirectly normalize to MNI template and smooth data) and statistical modeling. Lesions were masked and excluded from the normalization process. First-level t-tests examined task-related activation during CORR, TR, and UNTR picture naming (S1/ S2) and during CORR, PR, and UNPR picture naming (S3). Results Aphasic participants made significant gains in naming TR targets following the treatment phase and PR targets following the HP phase, even in the scanner. Contrasts by training condition and over time revealed partially overlapping ‘signature’ activity patterns that were unique to each aphasic individual. Within subject significant clusters had nearly identical voxels of peak activity across time and training/practice conditions. We present here two participants, one non-fluent (JBR) and one fluent (ACL), who both made behavioral progress during treatment and HP program (see Figure). JBR’s ‘signature’ pattern of activity (p<.05, FWE) included: • Generally smaller amplitude and spatial extent of activity over time, but slightly greater for TR/PR and UNTR/UNPR than CORR; ACL’s ‘signature’ pattern included: • Generally smaller amplitude and spatial extent of activity in network post-treatment, with greatest and most asymmetrically right hemisphere activity post-HP; • Activity in R posSTG decreased over time for CORR pictures while increasing over time for TR/PR pictures Discussion Short-term intensive treatment followed by a home practice program can produce enduring language improvements that provide rich opportunities for investigating treatment-induced neuroplasticity in aphasia. Given the high degree of individual variability in lesion location/extent, and the resulting variability in aphasia type/severity, it makes sense to examine treatment-induced changes in neural activity patterns within subjects where ‘signature’ patterns of activity are remarkably reliable across time.

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