Limited recovery of function after stroke remains a major problem for millions. Disability persists in many, especially when hand function is limited. Existing therapies are limited and many have difficulties with activities of daily living, even after rehabilitation. Electrical stimulation of the brain has been proposed and used in early studies to try and aid recovery. In animals, stimulation delivered to the brain at precise times may improve the effect of stimulation. By stimulating at the beginning of movements, or just after another part of the brain is active, recovery may be enhanced. We will use recent advances in implanted brain stimulator technology to place wires on the brain surface in patients who are recovering from stroke. We will stimulate the brain during therapy sessions. Healthier brain regions near the stroke area will be stimulated at the time of activity of brain regions right over the stroke. This will allow the two areas to strengthen their connection and improve the effect of therapy. We will measure motor function before and after these different stimulation patterns. This will establish the ability to perform these experiments safely, and show that patients can tolerate well these painless stimulation sessions. We will look at the strength of connections between brain regions and study the brain networks related to motor function. We believe these connections and networks will become stronger with brain stimulation. If successful, this preliminary study would offer a new form of treatment for stroke recovery.

Narrative Motor deficits after stroke are a major source of disability. Stimulation of the brain during therapy may accelerate recovery, especially of hand function. We will test a new form of stimulation that uses timing based on brain activity to improve recovery from stroke.