Stroke imaging and its usefulness in stroke prognosis Flashcards
Why is studying stroke recovery important?
- One of the biggest health problems we have in neurological science
- There is a stroke every 5 minutes in the UK
- About 1 in 5 people in the UK will have stroke
- 4th leading cause of death in the UK
What is the most common neurological cause of disability worldwide?
Stroke
1.2 million stroke survivors in the UK
How many people are living with the consequence of acquired brain injury in the UK?
3 million people
What is the economic burden in the UK for stroke?
Estimated at £26 Billion/year
What is one of the problem across the world for stroke?
It is considered as a single incident disease e.g. have stroke and do recovery at home
What is stroke?
Long term and chronic progressive disease like Alzheimer’s, Parkinson’s disease
What is the benefit of rehabilitation?
Providing patients with tools to maintain their recovery
What is FM-UL score?
A measure of motion impairments
What are you looking for in a FM-UL scores?
Minimum clinically important differences of about 6 points
What is stroke?
Quite heterogenous
Both in terms of location and damage
Why doesn’t the arm work in people that have stroke?
- Profound scapula instability
- Flaccid paralysis [profound weakness]
- Sensory loss or neglect of that side of space
- Apraxia
What are the new approach for promoting recovery after stroke?
- Want behavioural changes e.g. arm to move, to be able to speak, memory to be better
- Achieve this through a behavioural input
- Input will drive the output
- The output is behavioural
What are examples of behavioural input?
- Physiotherapy
- Occupational therapy
- Neuropsychology
- Speech language
- Motor training
What are the number of components for the behavioural input?
- Strength training
2. Training dexterity
What are the number of components for the behavioural output?
- Impairment
- Activity
- Participation
- Quality of life
What are the input and output relationships going to be modulated by?
Brain states e.g. anatomy of damage or plasticity
What does the modulation of the input and output relationship lead to?
Predictions
Outcome response to therapy
- Input is therapy
- Output is the response
- State is the modulator
What do you need to understand about the new approach for promoting recovery?
- Clinical phenotype
2. Brain scans and tracts
What are some examples of drugs that are modulators of brain state?
- Fluoroooxtine
2. Prozac
What can Fluoroxotin do?
Open periods of plasticity in the adult brain
- Enhance the effects of the training
