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MomTalk.com November 20, 2017:   The women's magazine for moms about children, family, health, home, fashion, careers, marriage & more


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Electrical Stimulation of Brain Improves Hand Function in Stroke Victims: Your Health


By Rallie McAllister, M.D., MPH


Chris Ware was healthy, active and just 25 years old when he suffered a debilitating stroke that left him paralyzed on the right side of his body.


Although strokes are most commonly experienced by older adults, they can occur at any age. According to the American Stroke Association, a stroke occurs in the United States about every 45 seconds, affecting an estimated 700,000 Americans each year.


Stroke is a type of cardiovascular disease that affects the blood vessels in and around the brain. There are two main types: ischemic and hemorrhagic.


An ischemic stroke occurs when a blood clot or other particles block an artery leading to the brain, resulting in a severe reduction in blood flow, or ischemia. Deprived of oxygen and nutrients, brain cells can begin to die within minutes.


A hemorrhagic stroke occurs when a blood vessel in the brain leaks or bursts, allowing blood to spill into the brain. The hemorrhage can occur as a result of uncontrolled high blood pressure, or after the rupture of a weak spot in one of the brain's blood vessels.


Chris Ware was diagnosed with an ischemic stroke. His doctors attributed it to a small, previously undetected defect in his heart, which allowed a blood clot to form and travel to a blood vessel in his brain.


After four days of treatment and recovery in the intensive care unit, his prognosis was less than favorable. "They told me that the damage caused by the stroke was so severe that I was never going to be able to walk or drive a car again," he said. "I just refused to accept that."


Ware spent five weeks in the hospital undergoing intensive rehabilitation therapy, and continued to receive occupational and physical therapy in the months that followed. He eventually regained the ability to walk and drive, but his right hand remained weak and less than fully functional.

"Tasks that may seem minor to other people were really major for me," he said. "Things like opening a can, tying a necktie or pouring a glass of milk were almost impossible."


Ware's experience is typical of many stroke victims. Although physical and occupational therapy can help restore some of the lost limb function, improvements generally reach a plateau within about three or four months.


Nearly half of stroke survivors continue to suffer from hand or arm impairments. The inability to perform simple activities can rob patients of their independence and significantly diminish their quality of life.


Seven years after his stroke occurred, Chris Ware's doctor asked him if he would be interested in enrolling in the EVEREST Stroke Study. The ongoing clinical trial is designed to evaluate the safety and effectiveness of a therapy called cortical stimulation in improving hand and arm function in stroke victims. Ware jumped at the chance.


According to neurosurgeon Gordon Baltuch, M.D., Ph.D., director of the Center for Functional and Restorative Neurosurgery at the University of Pennsylvania, "After an injury, like a stroke, the brain has a remarkable ability to heal itself and regain some of the lost function. Cortical stimulation therapy appears to enhance this process."


Cortical stimulation therapy involves the precise delivery of electricity to specific areas of the brain. "Functional magnetic resonance imaging, or fMRI, is used to identify the area in the brain that is responsible for the patient's hand movement," Baltuch explained.


Once the target area is identified, a surgeon makes a 4-centimeter, circular incision in the skull, and attaches small electrodes to the surface of the brain. A pacemaker-like device, called an implantable pulse generator, is then surgically placed beneath the surface of the chest.


Through thin, connecting wires that run under the skin of the neck, the implantable pulse generator delivers painless, low-level electrical currents to the electrodes on the brain. The generator is activated only while the patient is engaged in rehabilitation therapy of the affected limb.


Two clinical studies of stroke victims undergoing cortical stimulation have yielded positive results. Seventy-five percent of the patients who received cortical stimulation in conjunction with intensive rehabilitative therapy showed significant improvements in hand function.


"The results of these studies demonstrated that patients who received cortical stimulation plus rehabilitation therapy had greater improvements than those who received rehabilitation therapy alone," Baltuch said.


Chris Ware is living proof. "I can now do things that most other people take for granted, like tie my shoes and drive a car with two hands," Ware said. "This therapy has made a huge difference in my life."


Rallie McAllister, M.D., M.P.H., is a family physician in Kingsport, Tenn., and author of "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim."

COPYRIGHT 2006 CREATORS SYNDICATE, INC.



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