This Article Full Text Full Text (PDF) All Versions of this Article: 40/3_suppl_1/S139    most recent STROKEAHA.108.534925v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kent, T. A. Articles by Papanicoloau, A. C. Search for Related Content PubMed PubMed Citation Articles by Kent, T. A. Articles by Papanicoloau, A. C. Related Collections Rehabilitation, Stroke Other Stroke Treatment - Medical

(Stroke. 2009;40:S139.)
© 2009 American Heart Association, Inc.

Rehabilitation

What Is the Evidence for Use Dependent Learning After Stroke?

Thomas A. Kent, MD; Devon G. Rutherford; Joshua I. Breier, PhD Andrew C. Papanicoloau, PhD

From the Michael E. DeBakey VAMC Stroke Program and Department of Neurology (T.A.K., D.G.R.), Baylor College of Medicine, Houston, Tex; and the Center for Clinical Neurosciences in the Department of Pediatrics (J.I.B., A.C.P.), The University of Texas Health Science Center at Houston.

Correspondence to Thomas A. Kent, MD, Department of Neurology, Baylor College of Medicine and the Michael E. DeBakey VAMC, 2002 Holcombe Blvd, Houston, TX 77005. E-mail tkent@bcm.tmc.edu

Key Words: animal models • MEG • stroke recovery • synapse

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Our laboratory has been interested in the patterns of synaptic plasticity after cortical stroke in animal models.¹ These protein expression studies suggest that regions both ipsilateral and contralateral to the stroke are involved during the recovery period. An emerging issue of interest is whether the recovered function is indeed normal or reflects some compensatory function.² One approach to resolving these questions is to assess different patterns of functional recovery in patients who do and do not recover function with and without therapy and compare them to normal patterns.

Investigation of the molecular mechanisms of brain plasticity after injury suggests that functional activity stimulates this recovery and guides the development of functional pathways.^3,4 Several investigators postulate that recovery from stroke resembles "use-dependent" learning.⁵ For this report, we review pertinent literature related to this phenomenon, assess how recovery of language resembles normal language function, and provide examples from our own research on functional imaging that assess patterns of activation related to recovery. The primary treatment modality that we review is constraint-induced language therapy (CILT), in which stroke patients are restricted to using verbal communication.⁶

CILT is based on principles of constraint-induced therapy for other conditions.⁶ CILT is performed in chronic stroke patients with moderate aphasia by a visual physical barrier between participants and provided tasks they must communicate. Control subjects are allowed to use all forms of communication. In a recent report, the ability to communicate improved in both CILT and "control" aphasic subjects, but CILT-trained subjects used words more often whereas . . . [Full Text of this Article]