Brain Disorders & Therapy

New Approaches in Stroke Rehabilitation

Global Summit on Stroke

August 03-05, 2015 Birmingham, UK

Stefan Golaszewski

Keynote: Brain Disord Ther

Abstract:

Restoring sensorimotor, neuropsychological or cognitive functions after a stroke is usually unsatisfactory. At the same time
increases the stroke frequency, and the number of those who survive such an event and therefore have high hopes for the
rehabilitation treatment increases considerably in recent years. The talk provides an overview of new approaches in stroke
rehabilitation that are currently in the experimental stage or at the edge of daily clinical neurorehabilitation including also
pharmacologic agents for neuroenhancement.
Firstly, the lecture gives a comprehensive overview about the methods of peripheral electrical stimulation for enhancing
corticospinal excitability in stroke patients to improve sensorimotor function of the upper and the lower extremity. Different
levels of stimulation and different stimulation protocols in combination with motor training are discussed. A special method for
peripheral electrical stimulation with a mesh glove is presented. Results of single and paired-pulse transcranial magnetic stimulation
(TMS) and functional magnetic resonance imaging (fMRI) are presented to follow corticospinal excitability changes and to assess
cortical brain reorganization changes after a treatment period with the mesh glove. Effects of mesh glove stimulation are compared
to a control group receiving sham stimulation. A program with mesh glove stimulation to raise sensorimotor cortical excitability
in the lesioned cortex applied before a physiotherapeutic training to raise effectiveness of a subsequent motor training is presented.
In addition, peripheral vibration for enhancing corticospinal excitability and its neuromodulatory potential in stroke patients
will be discussed. The talk will further concern methods for central sensorimotor, neuropsychological and cognitive stimulation
by transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) for inhibition and
facilitation of lesioned and unlesioned brain structures for promoting cortical reorganisation after stroke. Another topic of the talk
will be functional electrical stimulation (FES)-assisted active cycling in comparison with active cycling without FES concerning
walking and balance in stroke patients. The results of a randomized controlled trail that was recently published in the Archives
of Physical Medicine and Rehabilitation will be summarized and potential applications of FES in stroke rehabilitation will be
discussed. Finally, the talk will deal with targets of a neuropharmacologic enhancement of sensorimotor, neuropsychological and
cognitive functions in stroke patients to promote recovery and will present pharmacologic agents that hold promise for a future
application in daily neurorehabilitation and will discuss its side effects and potential risks.

Biography :

Stefan Golaszewski worked as a Neurologist at the University Innsbruck from 1995 to 2001, where he focused on clinical applications for functional Magnetic
Resonance Imaging. From 2001 to 2002, he has worked at the Medical University. He has worked as Associate Professor at the Department of Neurology at the
Paracelsus Medical University (PMU) Salzburg in Austria since 2005 and focuses on the investigation of cortical reorganization after stroke. Since 2010, he is
Medical Head of the Neuroscience Institute of the PMU. He has published 120 papers in international peer-reviewed journals.