Paradoxical Motor Recovery From a First Stroke After Induction of a Second Stroke: Reopening a Postischemic Sensitive Period.
Steven R Zeiler, Robert Hubbard, Ellen M Gibson and 4 others
PMID 26721868WHAT IT FOUND
In mice, a second stroke in medial premotor area followed by training after 48 hours restored reach-to-grasp performance that had plateaued after a first stroke.
This was a small animal experiment, not a human treatment.
Key findings
01After the first stroke, training started after a delay produced only mild gains and never returned to pre-stroke performance.
02A second stroke in medial premotor area followed by training after 48 hours led prehension to return to the level seen before the first stroke.
03A control second stroke in occipital cortex did not produce significant worsening or subsequent improvement.
STILL TO COME
How it was doneWhat they found
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What it does not show
It is an animal study in mice, not a human clinical trial. Fifteen mice were studied and three were excluded, so the sample is small. The intervention was an additional brain stroke, which increased infarct volume and initially worsened the deficit. The authors state that inducing a second stroke is not a tenable therapeutic option for patients. The paper does not separate the contribution of the second stroke and the training that followed it. Baseline performance differences between groups were not significant and may reflect low power.
Declared interests
The authors declared no conflicts of interest. The article is listed as supported by NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not read this as evidence that therapists should change stroke rehabilitation timing in humans. It is a mouse experiment, and the authors state that inducing a second stroke is not a tenable therapeutic option for patients.