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Effective sensory rehabilitation after stroke: Targeting viable brain networks.

New therapies have been developed to help the brain recover after stroke, yet we do not have biological markers of identifying individuals who may benefit from these therapies nor how to select the most optimal therapy.  We propose a model of sensory recovery which identifies potential changes in brain regions and connections involved in sensory processing following lesions of sensory brain regions and pathways.

Aims

The CoNNECT study aims to investigate changes in brain activity that may be associated with the recovery of people’s ability to “feel things” following a stroke. This includes:

  • Identify and compare changes in functional connections in brain networks associated with sensory rehabilitation in stroke patients with somatosensory lesions in cortical or subcortical brain regions
  • Predict ability to benefit from sensory rehabilitation based on structural connections of interhemispheric and thalamo-cortical tracts between key somatosensory regions
  • Develop a data driven model of somatosensory recovery following cortical and subcortical lesions, based on evidence of functional and structural connections in the brain

Stroke patients (at least 3 months post stroke) were randomised into one of three treatment packages. Patients are assessed at baseline, following 6 weeks of training or no-training (post 1), then again following 6 weeks of training or no-training (post 2), then finally at a 3 month follow up session. Age matched healthy controls are tested at 2 time points, 6 weeks apart, to provide comparison. Assessments include demographic information, clinical assessments of recovery, sensation, motor, cognition and mood, and advanced imaging allowing for analysis of functional resting-state connectivity, structural connectivity, task-related activation (involving a sensory paradigm) and anatomy. An example of changes in the brain is provided in the figure below.

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