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Retraining brain, body

Doctors seek better stroke recovery


Zettie Williams, monitored by occupational therapist Valerie Hill, uses a prosthetic device that stimulates the muscles in her arm and hand as part of her rehabilitation from a stroke.


Zettie Williams' right hand is frozen shut.
She had a stroke in November 2004, and now a small portion of her brain can't transmit the electrical signals that allow the muscles in her hand to open and close.
Williams, 50, of Westwood, is working to re-train her brain so she can get back to normal life.
"I want to be able to comb my hair," she said.
Part of her therapy includes using a prosthetic device that stimulates the muscles in her arm and hand. Doctors said they hope the artificial stimulation will repair the damaged nerve pathways from her brain to her right arm.
The device Williams uses is one of the innovative approaches local doctors are studying to help stroke survivors recover better and faster.
Researchers at the University of Cincinnati are studying the safety and effectiveness of electrically stimulating the brain to improve hand and arm function months - even years - after a stroke. UC is one of 17 sites participating in the national study.
In a second study, investigators with the Mayfield Clinic and the Neuroscience Institute are trying to find out if a combination of a clot-busting drug and surgery can eliminate large blood clots caused by bleeding in the brain to help minimize damage immediately after a stroke.
Every year, an estimated 700,000 Americans suffer strokes, and 157,000 die from them. Stroke is the third-leading cause of death in the United States. This year, Americans will pay $58 billion for medical care and indirect costs associated with stroke, according to the American Heart Association.
Williams has made progress since her stroke. She can speak again, though her words are a little slurred, and her memory is good enough that she rattles off the recipe for cornbread stuffing she plans to make for a friend's wedding.
But she can't hold a spoon or spatula in her right hand to mix the stuffing or lift a pan off the stove.
So most days of the week, she does a series of exercises using the prosthetic device. It wraps around her hand and forearm like a brace, and five electrodes deliver a gentle current that relaxes the frozen muscles in her hand long enough to let her practice holding a spoon, lifting a brush to her hair and folding a dishcloth.
It doesn't hurt, Williams said. "But I can feel it working on my hand."
She gets occupational therapy at the Drake Center in Hartwell in a project with physical medicine and rehabilitation specialists from the University of Cincinnati.
Williams' prosthetic device works on her arm and hand. Stephen Page, research director for UC's physical medicine and rehabilitation department, is studying whether implanting electrodes directly on the brain will help stroke survivors regain the use of their hands and arms.
Patients who receive the implant do physical therapy and exercises while the electrodes are turned "on" to help the brain re-establish communication with the paralyzed limb.
In the other study, researchers with the Neuroscience Institute and the Mayfield Clinic want to know if combining minimally invasive surgery with a well known clot-busting drug can treat a type of bleeding stroke.
Some patients who suffer spontaneous bleeding in the brain develop large blood clots that can cause strokes.
Mario Zuccarello, a neurosurgeon at the University of Cincinnati and the Mayfield Clinic, is one of the investigators heading up the national study.
In the study, surgeons will make a quarter-inch incision at the clot, then insert a small tube containing a clot-busting medication. The medication is delivered to the site over the course of a few days.
Breaking up the clot quickly minimizes damage to brain tissue.
Bleeding strokes are rarer than those caused by blood clots, but they tend to cause more disability and death.