Stroke is the leading cause of motor disability in the United States, affecting 750,000 people per year. Recent work in animal models suggests that there is a limited window of heightened plasticity in the first four weeks after ischemic injury. Data suggest that there is likely a similar window in humans after stroke, although it may last longer than four weeks but probably not more than 3 months. The argument will be made that we need to find novel interventions that augment and extend this plasticity window because current rehabilitation fails to do so. These interventions could include robotic therapy, virtual reality, videogames, and non-invasive brain stimulation. It is to be hoped that collaborative efforts between computer scientists, video-game designers, roboticists, neuroscientists, and neurologists will help solve a problem that so far has proved intractable.
Dr. John Krakauer, is a neurologist and neuroscientist with an interest in the healthy and damaged motor system. He was an Associate Professor of Neurology and co-Director of the Motor Performance Laboratory at Columbia University up until 2010. He is now is the Director of the Center for Motor Learning and Brain Repair at Johns Hopkins University where he studies motor learning and control in patients after stroke and their relationship to functional recovery. There is a critical need to establish whether motor learning itself is affected after stroke and to determine which forms of motor learning should be the focus of rehabilitation strategies. He have made a number of observations/contributions to the study of motor learning in healthy subjects and motor recovery after stroke that suggest new directions for the treatment of impairment early after stroke.