Stroke

The following information is a summary of an article on stroke and rehabilitation from the National Stroke Association. For the full article visit their website at:

http://www.stroke.org/site/PageServer?pagename=REHABT

Recovery & Rehabilitation

Current statistics indicate that there are more than 7 million people in the United States who have survived a stroke or brain attack and are living with the after-effects.

Early Recovery

There’s still so much we don’t know about how the brain compensates for the damage caused by stroke or brain attack. Some brain cells may be only temporarily damaged, not killed, and may resume functioning. In some cases, the brain can reorganize its own functioning. Sometimes, a region of the brain “takes over” for a region damaged by the stroke. Stroke survivors sometimes experience remarkable and unanticipated recoveries.

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HYPNOSIS AND STROKE

Several studies show that hypnosis is effective in recovering from stroke (only the abstracts from the studies have been reproduced here)

Hypnosis for Rehabilitation After Stroke: Six Case Studies

In: Contemporary Hypnosis 23(4): 173-180 (2006). DOI: 10.1002/ch.319

Solomon G. Diamond (Harvard University, Massachusetts General Hospital); Orin C. Davis(Massachusetts General Hospital); Judith D. Schaechter (Massachusetts General Hospital); Robert D. Howe(Harvard University).

Abstract

This report presents qualitative accounts from a pilot clinical study of six chronic stroke subjects. Our hypothesis was that a hypnotic procedure would help overcome learned nonuse, which is thought to contribute to impaired motor function of the paretic upper limb in chronic stroke patients. The hypnotic procedure involved selecting motor tasks that would challenge each subject, then (1) imagined practice of the challenging motor task revivified from prior to the stroke alternated with imagined practice in the present; (2) imagined practice in the present alternated with imagined practice during active-alert hypnosis; and (3) active-alert imagined practice alternated with actual physical performance. We observed qualitative improvements in motor function related to increased range of motion, increased grip strength, and reduced spasticity of the paretic upper limb. Subjects consistently reported an improved outlook, increased motivation, as well as greater awareness of and decreased effort to perform motor tasks with the paretic limb. (Copyright © 2006 British Society of Experimental & Clinical Hypnosis. Published by John Wiley & Sons, Ltd.)

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Talking to the Senses: Modulation of Tactile Extinction through Hypnotic Suggestion

Angelo Maravita, Mario Cigada, and Lucio Posteraro Front Hum Neurosci. 2012; 6: 210. Published online 2012 July 17. doi: 10.3389/fnhum.2012.00210 PMCID: PMC3398471

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398471/

Abstract

Following brain damage, typically of the right hemisphere, patients can show reduced awareness of sensory events occurring in the space contralateral to the brain damage. The present work shows that a hypnotic suggestion can temporarily reduce tactile extinction to double bilateral stimulation, i.e., a loss of contralesional stimuli when these are presented together with ipsilesional ones. Patient EB showed an improved detection of contralesional targets after a single 20-min hypnosis session, during which specific suggestions were delivered with the aim of increasing her insight into somatosensory perception on both sides of the body. Simple overt attention orienting toward the contralesional side, or a hypnotic induction procedure not accompanied by specifically aimed suggestions, were not effective in modulating extinction. The present result is the first systematic evidence that hypnosis can temporarily improve a neuropsychological condition, namely Extinction, and may open the way for the use of this technique as a fruitful rehabilitative tool for brain-damaged patients affected by neuropsychological deficits.

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Gene Expression and Brain Plasticity in Stroke Rehabilitation:

Ernest Lawrence Rossi Ph.D. (The following is an excerpt from the article at Dr. Rossi’s website. The full article can be read here: http://www.ernestrossi.com/ernestrossi/keypapers/PG%20GE%20PB%20Stroke.pdf

… It is now intimated in neuroscience that facilitating gene expression and brain plasticity (involving synaptogenesis as well as neurogenesis by stem cell differentiation and maturation in the brain) via activity-dependent cognitive-emotional-behavioral experiences is a basic mechanism of healing that makes rehabilitation possible (Cohen-Cory, 2002; Kandel, 1998; Nakatomi et al., 2003; Rossi, 2002b, 2003a, b & c). Patients with severe trauma resulting in loss or paralysis of sensory-motor functions due to physical injury, cardio-vascular accidents, stroke, etc., for example, can recover their abilities via occupational and physical therapy that works primarily by activating their behavior (Spedding et al. 2003). Until recently this molecular-genomic mechanism of rehabilitative healing by behavioral activation was not understood. The new neuroscience hypothesis is that cognition and behavioral action initiates activity-dependent gene expression.

This activity-dependent gene expression initiates healing by the generation of proteins that facilitate brain plasticity and stem cell differentiation into new tissues that can be initiated within minutes and continue for the hours, days, and weeks required for full rehabilitation (Gage, 2000; Kempermann et al. 1997, 1999; Van Praag et al., 2002)….

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Pushing the Limits of Recovery: Hypnotherapy with a Stroke Patient.

Holroyd J, Hill A. (PMID: 2722301 [PubMed – indexed for MEDLINE])

Abstract

Hypnotherapy was used to assist recovery of left arm function following stroke in a 66-year-old woman. Treatment protocol is described, and results are discussed in terms of how hypnosis may facilitate voluntary motor movement. Recent literature on cortical changes in hypnosis and motor improvement during hypnosis is discussed in relation to the present results.

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