Background: Disability resulting from stroke and traumatic brain injury represent the main cause of long term disability among adults. There are no universally accepted treatments available for the treatment of this condition and the financial, personal, familiar and social cost of this disability can not be underestimated. Preliminary data from different laboratories has shown that it is possible to modulate plastic processes in the lesioned brain by pharmacological, brain stimulation and somatosensory stimulation techniques. The purpose of this Z01 is to characterize the most promising techniques to improve cortical plasticity in these patients in order to enhance functional recovery.? Findings this year: This year we found that action observation can enhance the beneficial effects of rehabilitative treatments after chronic stroke. We identified fMRI correlates of functional recovery after traumatic brain injury. We demonstrated the value of somatosensory stimulation of the paretic hand and anaesthesia of the intact hand to enhance motor function after stroke and the beneficial effects of motor training in this patient group. We have used multimodal imaging to further understand substrates underlying functional recovery after stroke. We have advanced our understanding of the way in which different forms of brain stimulation can contribute to neurorehabilitative processes following stroke. We have found that the magnitude of improvements in motor function elicited by somatosensory stimulation appear to be more prominent in patients with relatively lower Fugl-Meyer scales within limited boundaries.? Our future plans include advancing our understanding of the mechanisms by which each of these different stimulation techniques contribute to recovery of memory and motor functions. Additionally, we will try to determine the optimal parameters of stimulation and techniques to enhance the beneficial effects of this intervention on neurorehabilitative treatments. ? Implications: The significance of this project is that it can lead to a better understanding of the mechanisms underlying rehabilitative processes and to the development of more effective interventions to improve neurological outcome after stroke and traumatic brain injury using brain stimulation techniques.
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