Researchers at Harvard Medical School, the Massachusetts Institute of Technology and the San Camillo Hospital in Venice report they have found a process to observe and decode the way the nervous system controls muscles after a stroke. This discovery could lead to new rehabilitation interventions tailored specifically for each person’s unique nervous system characteristics that could help patients to recover function lost due to a stroke.
“In patients who recently suffered a stroke and are affected by mild impairments, we observed that the central nervous system ‘speaks’ the same ‘alphabet’ that is spoken by healthy systems. However, the alphabet spoken by the central nervous system of patients who are affected by severe impairments is different,” said Paolo Bonato, director of the Motion Analysis Lab at Spaulding Rehabilitation Hospital and assistant professor of physical medicine and rehabilitation at HMS. “This is important because deciphering the alphabet spoken by each patient’s central nervous system opens the possibility of a broad range of new rehabilitation interventions focused on recovering/rebuilding a correct alphabet.”
The paper, published in the Proceedings of the National Academy of Sciences, is based on a technique enabling the study of muscle control developed at the MIT McGovern Institute for Brain Research by co-authors Emilio Bizzi and Vincent Cheung. The technique demonstrated that the central nervous system controls muscles by simultaneously sending common commands to multiple muscles rather than controlling each muscle in isolation.
By using an alphabet of commands that allows for the simultaneous control of multiple muscles, the central nervous system can achieve the task of controlling movement in a relatively simple way. In stroke patients, the central nervous system manages with time to generate new letters of the alphabet that are not part of the standard alphabet. Such new letters are used to compensate for the inability of the central nervous system to generate the standard letters.
“The findings could lead to improved rehabilitation for stroke patients, as well as a better understanding of how the motor cortex coordinates movements,” said Bizzi, an Institute Professor at MIT.
The work is one of several partnerships between the MIT McGovern Institute for Brain Research and the HMS Department of Physical Medicine and Rehabilitation at Spaulding. The goal of those involved with the study is to develop new therapeutic protocols with rehabilitation providers nationally.
“The ability of deciphering the alphabet spoken by each patient’s central nervous system provides the opportunity to individualize interventions. The hope is that we can now develop rehabilitation techniques designed to teach the central nervous system how to speak a proper language again,” said Bonato.
Together with their collaborators at MIT, Dr. Bonato and the Motion Analysis Lab team are now exploring the modifications in the alphabet spoken by the central nervous system of stroke survivors when they receive robot-assisted rehabilitation interventions. By understanding the alphabet post stroke, researchers hope to gain the ability to program new robotic devices to speak the language of a central nervous system and empower quicker recovery and rebuilding of a fuller range of movement.
Bonato and his team, whose lab is based at Spaulding Rehabilitation Hospital in Boston, see patients and families each day whom they hope this work will benefit. “The publishing of this study today will enable the language of movement and muscles for those recovering from stroke to be understood by rehabilitation providers in completely new and productive ways.”
The research was funded by the National Institutes of Health and the Italian Ministry of Health.
Adapted from a Spaulding Rehabilitation Hospital news release.
