Many surviving stroke patients are left with moderate to severe functional deficits and long-term dependency on rehabilitation services. The most common functional deficits after stroke are sensorimotor impairments, especially no or limited ability to execute muscle movements with the affected arm or hand, and language deficits.
With imaging-based research, involving high-field MRI of neural network organization, optical imaging of neuronal activity, and MR spectroscopic imaging of neurotransmitter metabolism, we are attempting to determine how neurorestorative mechanisms contribute to functional recovery, and how these processes may be therapeutically enhanced.
We have recently initiated a translational research program that aims to establish safe and effective modulation of neural networks to enhance functional recovery after stroke through non-invasive brain stimulation. Studies include testing the applicability and efficacy of different neurostimulation and –modulation strategies – e.g. based on transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) – in animal stroke models and hemiparetic stroke patients. This program includes a clinical trial, B-STARS (Brain STimulation for Arm Recovery after Stroke), in which we test if repetitive TMS has therapeutic effects in subacute stroke patients with hemiparesis.
Noninvasive Brain Stimulation to Enhance Functional Recovery After Stroke: Studies in Animal Models. Boonzaier J, van Tilborg GAF, Neggers SFW, Dijkhuizen RM. Neurorehabil Neural Repair. 2018;32(11):927-940.
Etiology of language network changes during recovery of aphasia after stroke. van Oers CAMM, van der Worp HB, Kappelle LJ, Raemaekers MAH, Otte WM, Dijkhuizen RM. Sci Rep. 2018;8(1):856.
Brain stimulation for arm recovery after stroke (B-STARS): protocol for a randomised controlled trial in subacute stroke patients. van Lieshout ECC, Visser-Meily JMA, Neggers SFW, van der Worp HB, Dijkhuizen RM. BMJ Open. 2017;7(8):e016566.
Assessment and modulation of resting-state neural networks after stroke. Dijkhuizen RM, Zaharchuk G, Otte WM. Curr Opin Neurol. 2014;27(6):637-43.
Can diffusion kurtosis imaging improve the sensitivity and specificity of detecting microstructural alterations in brain tissue chronically after experimental stroke? Comparisons with diffusion tensor imaging and histology. Umesh Rudrapatna S, Wieloch T, Beirup K, Ruscher K, Mol W, Yanev P, Leemans A, van der Toorn A, Dijkhuizen RM. Neuroimage. 2014;97:363-73.
Extent of bilateral neuronal network reorganization and functional recovery in relation to stroke severity. van Meer MP, Otte WM, van der Marel K, Nijboer CH, Kavelaars A, van der Sprenkel JW, Viergever MA, Dijkhuizen RM. J Neurosci. 2012;32(13):4495-507.
Increase in sensorimotor cortex response to somatosensory stimulation over subacute poststroke period correlates with motor recovery in hemiparetic patients. Schaechter JD, van Oers CA, Groisser BN, Salles SS, Vangel MG, Moore CI, Dijkhuizen RM. Neurorehabil Neural Repair. 2012;26(4):325-34.
1H/13C MR spectroscopic imaging of regionally specific metabolic alterations after experimental stroke. van der Zijden JP, van Eijsden P, de Graaf RA, Dijkhuizen RM. Brain. 2008;131(Pt 8):2209-19.
Manganese-enhanced MRI of brain plasticity in relation to functional recovery after experimental stroke. van der Zijden JP, Bouts MJ, Wu O, Roeling TA, Bleys RL, van der Toorn A, Dijkhuizen RM. J Cereb Blood Flow Metab. 2008;28(4):832-40.
Structural and functional plasticity in the somatosensory cortex of chronic stroke patients. Schaechter JD, Moore CI, Connell BD, Rosen BR, Dijkhuizen RM. Brain. 2006;129(Pt 10):2722-33.