Evidence of Post-Stroke Brain Recovery Seen on MRI

The world's largest study using neuroimaging of stroke patients struggling to regain the ability to communicate revealed that brain cells outside the injured area could take on new roles.

Dr. Fridriksson, a researcher from the University of South Carolina's Arnold School of Public Health (Columbia, USA), reported that the findings offer hope to patients of "chronic stroke,” characterized by the death of cells in a specific area of the brain. The damage results in long-term or permanent disability.

"For years, we heard little about stroke recovery because it was believed that very little could be done,” Dr. Fridriksson said. "But this study shows that the adult brain is quite capable of changing, and we are able to see those images now. This will substantially change the treatment for chronic-stroke patients.”

The study, reported in the September 15, 2010, issue of the Journal of Neuroscience, involved 26 patients with aphasia, a communication disorder caused by damage to the language regions in the brain's left hemisphere.

Approximately 35% of stroke patients have speech and/or communication problems. While many patients with aphasia regain some language function in the days and weeks after a stroke, scientists have long believed that recovery is limited after this initial phase. "Stroke is the leading cause of disability among adults, more than accidents or complications from Parkinson's or Alzheimer's diseases,” said Dr. Fridriksson, director of the university's Aphasia Laboratory and an associate professor in the department of communication sciences and disorders. "When someone has brain damage as a result of a stroke, the recovery is expected to be limited,” he said.

However, Dr. Fridriksson's study revealed that the brain can recover and that a patient's ability to communicate can improve. Stroke patients underwent an imaging test, called functional magnetic resonance imaging (fMRI), which measures brain activity. Patients received multiple MRI sessions before and after undergoing 30 hours of conventional speech therapy used to improve communication function in patients with aphasia.

By employing fMRI--an imaging technique more improved and widely used in the past decade--Dr. Fridriksson was able to see the healthy areas of the brain that "take over” the functions of the areas injured as a result of a stroke. "The areas that are immediately around the section of the brain that was damaged become more ‘plastic,'” Dr. Fridriksson noted. "This ‘plasticity,' so to speak, increases around the brain lesions and supports recovery. In patients who responded well with the treatment for anomia, their fMRI showed evidence that areas of the brain took over the function of the damaged cells.”

The study found that patients who did not experience these changes did not have as improved a recovery, according to Dr. Fridriksson.

This study lays the foundation for future research of aphasia, including the study on the use of low-current, electrical stimulation for the brain. "Knowing where the brain has been damaged--and the section that is taking over that function--will enable us to better use electrical stimulation to promote recovery,” commented Dr. Fridriksson, the lead author of another study published August 2010 in the Journal of Neuroscience that examined the mapping of brain lesions that cause speech/communication impairment. "It is believed that electrical currents to the brain will promote secretions of neurotransmitters that support brain plasticity. This could dramatically improve the quality of life for stroke patients.”

Related Links:
University of South Carolina's Arnold School of Public Health