Stroke therapy research earns grant approval

Dr. Stephen Nadeau, professor of neurology at the College of Medicine, recently was awarded funding from the Veteran’s Affairs Rehabilitation Research and Development program for his efforts to improve treatments for stroke patients.

The VA-funded research will study the effectiveness of combining constraint-induced movement therapy (CIMT) with the drug d-cycloserine, which has been shown to promote learning in animal models.

The trial also will compare the success of a given amount of physical therapy administered in concentrated form over a short time with the same amount administered over a longer time. The better long-term retention of learning achieved over more extended periods of time, known as the spacing effect, has been demonstrated in hundreds of experiments over the last century, explained Nadeau, but not in people who have suffered brain damage.

“We will have some patients work in therapy for six hours a day for 10 days,” said Nadeau, a staff neurologist with the Geriatric Research and Educational Clinical Center at the VA Medical Center and the medical director of the VA Brain Rehabilitation Research Center. “The other group will spend two hours a day, three days a week for 10 weeks.”

With 60 hours of physical therapy for each group, researchers will later determine if therapy that was spread out rather than concentrated was more successful.

Constraint-induced movement therapy, or CIMT, is a rehab technique used to help stroke patients regain motor skills in hand and arm affected by the stroke. During therapy, participants’ least-affected hand is constrained in a mitt for 90 percent of the time they are awake while they use the most-affected hand to accomplish everyday activities.

“The goal is to train the patients to use that affected hand in more day-to-day activities to, at the very least, make small improvements and help improve their quality of life,” said Nadeau, a 1977 graduate from the College of Medicine. “This is not new, but the question we are looking at is how to make it better.”

Nadeau said the VA-trials will help physicians and scientist determine if adding d-cycloserine to CIMT will give the patient “more bang for their buck,” promoting higher levels of learning during the therapy.

Funding for the two-tiered research project is very important to the work being done at the department of neurology and the VA, said Leslie J. Gonzalez Rothi, Ph.D., program director of the VA Brain Rehabilitation Research Center.

“This is an important project targeting the development of one treatment for stroke, which is the single most handicapping chronic health condition of adults worldwide,” Rothi said. “And considering the highly competitive climate of extramural federal grant funding, securing this grant is a significant achievement.”