Robotic Stroke Rehab Tool Friday, Dec 5 2008 

robotic-tool1Researchers have recently used a custom hand exercise robotic machine and fMRI brain imaging to help chronic stroke patients restore some functioning. The robotic machine was used for doing several rehabilitation exercises. The doctors monitored the changes in the fMRI as the patients regained some of their previous functioning. This is basically using the brain’s neuroplastic mechanisms to restore some previous functioning. Here is the press release.

CHICAGO — Research scientists using a novel, hand-operated robotic device and functional MRI (fMRI) have found that chronic stroke patients can be rehabilitated, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA). This is the first study using fMRI to map the brain in order to track stroke rehabilitation.

“We have shown that the brain has the ability to regain function through rehabilitative exercises following a stroke,” said A. Aria Tzika, Ph.D., director of the NMR Surgical Laboratory at Massachusetts General Hospital (MGH) and Shriners Burn Institute and assistant professor in the Department of Surgery at Harvard Medical School in Boston. “We have learned that the brain is malleable, even six months or more after a stroke, which is a longer period of time than previously thought.”

Post-stroke rehabilitation is nothing new and has already been reported by researchers in the past. See here and also here and here. So this is not the first time that fMRI has been used to track progress among stroke patients and the press release may be wrong. It has also been known for some time that the brain’s neuroplasticity allows for improved functioning that can be quite long lasting. However, this may be the first use of a robotic device such as the one used.

fmri-image5

Figure 16. This fMRI image illustrates the area in the brain that corresponds with hand use of a patient before training (left), after eight weeks of training (middle), and one month after training was completed (right) at a 60percent effort level.

In the future researchers may use real time brain imaging to shape the brain among those who are brain injured. It would allow real-time feedback. A person would be able to look at their own brain scan and attempt to change their own brain waves by themselves. It could potentially shape the brain for beneficial effect among those who currently have poor functioning as a result of brain injuries.

Brain Injury Screening War Troops Friday, Dec 5 2008 

soldiers1The Institute of Medicine is a government advisory group. This group studies a variety of medical and health issues. They have now issued a new report that urges the US government to screen soldiers who have had traumatic brain injury.

Traumatic brain injury has been a far too common occurrence in the Afghanistan and Iraq wars. Currently as of January and astounding 5,500 US military soldiers have suffered traumatic brain insults that are the result of improvised explosive devices.

The new study has indicated that those soldiers who experience these traumatic brain insults may be more likely to get some long term debilitating conditions. They are at increased risk for having Alzheimer’s dementia, major depression, memory loss and aggression.

The Institute of Medicine has currently recommended that the Department of Defense should devote more money and research to better protecting soldiers against this type of damage. The committee has also suggested that more studies should be performed on the long term side effects of the brain injuries.

The new report by the Institute of Medicine can be found here.

Under a Congressional mandate, the Institute of Medicine (IOM) has reviewed a wide array of biologic, chemical, and physical agents to determine if exposure to the agents might be responsible for the veterans’ long-term health problems. In this 2008 report, Gulf War and Health, Volume 7: Long-term Consequences of Traumatic Brain Injury, the IOM assesses the possible long-term health outcomes of traumatic brain injury (TBI).

The committee details numerous outcomes that might be associated with mild, moderate, and severe injuries. These include: neurologic, endocrine, psychologic outcomes, in addition to problems with social functioning.

In addition to the report’s findings, recommendations are provided for study of blast injuries and the report suggests methods of data-gathering for future research to improve our understanding of blast injuries which ultimately would improve veteran care. The report is part of the IOM’s Gulf War and Health series and was sponsored by the U.S. Department of Veterans Affairs.