Research promises new hope for mild stroke sufferers unable to hold a job

December 04, 2001

There may be new hope for people who have suffered a mild stroke and find themselves unable to hold a job because of a reduced ability to concentrate and perform tasks in a consistent manner.

Clinical and scientific researchers in Canada and the U.S. are teaming up on a rehabilitation study to identify more effective treatments to help mild stroke patients improve their attentional control, motor skills and response consistency.

The American-based James S. McDonnell Foundation has awarded a $2 million dollar grant for a collaborative research project to be undertaken by The Rotman Research Institute (RRI) at Baycrest Centre for Geriatric Care in Toronto and Washington University School of Medicine in St. Louis.

"Cognitive loss after a stroke, even a mild stroke, can have a devastating effect on a person's quality of life," says Dr. Donald Stuss, Director of the RRI and a principal investigator. The ability to read, write and sustain attention and concentration, can diminish to the point where it affects work and one's enjoyment of life.

"The good news is that the brain has been shown to be more adaptable and flexible than we once thought and we want to capitalize on this," explains Dr. Stuss. "We want to develop rehabilitation techniques that target specific deficits and see how this may improve a person's cognitive and functional abilities. We'll use magnetic resonance imaging and other imaging techniques to determine if therapies are causing the brain to change and reorganize."

Researchers will conduct two separate studies. The first will focus on the cerebellar-frontal lobe system. Previous research has shown that the frontal lobes may be important for the ability to sustain attention and perform tasks consistently; the cerebellum has been associated with motor function and gait. Researchers suspect that, even though connected and seemingly showing some similarities in function, each area is affected differently by mild stroke and therefore requires its own specific rehabilitation.

The second study will attempt to determine why persons with apparently "fully resolved" stroke fail to return to their prestroke level of function. These participants will undergo cognitive and psychosocial skills training to see if such therapies improve their cognitive and motor skills, and emotional health.

The approach is transdisciplinary, with scientists at the Rotman and Kunin-Lunenfeld Applied Research divisions at Baycrest, University of Toronto, and the Cognitive Rehabilitation Research Group at Washington University School of Medicine, combining their different skills and knowledge to collaborate on the study. They will work with adults who have damage to the frontal lobes and cerebellum as a result of mild stroke or other traumatic brain injury.

"To the best of our knowledge, a rehabilitation study using functional imaging, discrete focal lesion analysis and functional outcome to address questions of this magnitude and specificity, has never been done before," says Dr. Carolyn Baum, Director of the Program in Occupational Therapy at Washington University School of Medicine. Her research focuses on enabling older adults with disability to live independently.
In 1998, The Rotman Research Institute was awarded a $600,000 US grant from the McDonnell Foundation, earmarked over four years, to improve diagnosis, treatment and rehabilitation of patients with neurological and psychiatric disorders.

Baycrest Centre for Geriatric Care

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