Brain implant helps stroke survivors regain movement

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The Cleveland Clinic was looking for volunteers disabled by a heart attack or cerebrovascular accident , also known as a stroke, to undergo an experimental procedure aimed at returning movement to the upper body. It would involve having a very thin wire placed in your cerebellum to stimulate your neurons using electricity . After suffering a stroke in 2018, Nicholas barely moved his left side and couldn't prepare meals like he used to, something he loved.

He met the requirements, but when it came time for the operation, he thought abo Phone Number List ut backing out. “He was terrified,” Nicholas confesses. But if there was a chance to use his left arm and hand again, he decided it would be worth it.

Nicholas is currently one of 12 stroke patients in a new Nature Medicine study who underwent a technique called deep brain stimulation , or DBS . At the start of the trial, all participants had weakness on one side of their upper body, making it difficult for them to perform everyday tasks. But after treatment, Nicholas and eight other volunteers experienced significant improvements in hand and arm movement. For him, it was equivalent to recovering his culinary skills. “He gave me a sense of freedom,” he shares.

Deep Brain Stimulation for Stroke Recovery
Each year, about 15 million people worldwide suffer a stroke, which occurs when a sudden hemorrhage or blockage of blood flow to the brain occurs. As a result, neurons near the stroke site are damaged. Approximately half of those who survive such a heart attack suffer from chronic or permanent disabilities that affect their daily lives. Although physical therapy is helpful, recovery usually plateaus about a year after the stroke, when they stop improving.

At the Cleveland Clinic, researchers have been studying whether deep brain stimulation can enhance recovery from a stroke. The technique has been used for more than 30 years to relieve tremors in Parkinson's patients, and scientists are currently testing its ability to treat severe cases of depression and other psychiatric illnesses. It involves surgically implanting electrodes that emit gentle pulses of electricity. Scientists believe that DBS helps regulate abnormal electrical patterns in the brain , similar to a pacemaker for the heart.

The brain has a remarkable capacity to adapt in response to injury. Healthy regions take on functions that were previously performed by damaged parts. “We tried to create more favorable conditions for functional reorganization in the surviving areas of the cerebral cortex,” says Kenneth Baker, a neuroscientist at the Cleveland Clinic and author of the work.

A stroke decreases the excitability of neurons, that is, their ability to send signals and establish connections with other parts of the body. In people who recover spontaneously from a stroke, it is restored. With stimulation, Baker's team aimed to increase the excitability of neurons near the damaged area and strengthen their ability to form new connections.

In the Cleveland Clinic study, all 12 patients suffered strokes in the cortex, the outermost layer of the brain. Previous studies have attempted to directly stimulate this area without success. Instead, Cleveland's team focused on a part of the cerebellum, located at the back of the head and called the dentate nucleus , a group of neurons involved in the precise control of voluntary movements and sensory functions. This area establishes connections with other brain regions, including the cortex.



Surgeons implanted an electrode in each patient's brain, along with a device under the skin of the chest, which emits electrical impulses. After a recovery period from the operation, the patients underwent two months of physical therapy. The researchers then turned on the electrical stimulation and left it for four to eight months, while the participants continued with the physical treatment.

The researchers measured each person's progress by administering a common test that assesses hand and arm function after a stroke. Physical therapy alone produced a modest improvement of about three points on a scale of 66. After activating stimulation, the average rose another seven points.

Participants also improved in performing everyday tasks, such as using a comb, holding a cup, and turning on a light switch. “Their mobility and movement are not in the normal range, but even the ability to use their hand at a faster rate than they used to makes a big difference,” Baker says. The three patients who did not experience significant improvements began with worse deficits than the others.

Nicholas began to notice a difference after a few months with active stimulation. He was able to raise his arm above his head and close his left hand, actions that were impossible to do before receiving the implant. He has made yard work and household chores easier for her. “I'm happy that it benefited me,” he says.