cbd oil for paralysis after stroke

Can Brain Implants Improve Mobility After Stroke?

PHILADELPHIA , Feb. 1, 2021 /PRNewswire/ — Someone has a stroke every 40 seconds in the US, resulting in death every 4 minutes. Stroke is the leading cause of disability from a medical condition. When it happens, blood clots or bleeds kill a part of the brain – it goes dark – and can no longer control part of the body. People stop being able to walk, see, talk, or control their hand or arm the way they once did. Although treatments exist, they only work within a short window from the start of a stroke. Rehab can restore some function, but improvements typically plateau in about 6 months.

Now, researchers at Jefferson have initiated a clinical trial using a brain implant and robotic brace to test a method that could one day offer hundreds of thousands of stroke patients with long-term disability a new option for better mobility.

"This is the first person ever with this very common type of stroke to be implanted with brain electrodes that send neuronal signals to an arm brace that then controls movement," says principal investigator of the study Mijail Serruya , MD, PhD, an assistant professor of neurology at Thomas Jefferson University , who was part of the team that implanted the first human with a brain electrode 15 years ago. "This study serves as a proof of concept, a necessary bridge to future studies that would use fully implanted wireless electrodes to improve movement after stroke."

In the past, other clinical trials of brain-computer interface, or BCI, focused on patients with the much more rare and devastating form of brainstem stroke or spinal cord injury that causes paralysis from the neck down, or even locked-in syndrome that renders patients incapable of movement. In those patients, electrodes that recorded brain signals were implanted in the brain tissue and connected by wires extending through the skull to a computer. Their neuronal signal — their intention to move — was then decoded and interpreted by artificial intelligence algorithms into moving a cursor on a screen, a robotic arm or muscle stimulators. Patients with virtually no ability to control their movement were able – with training – to convert their thoughts into signals that controlled a number of electrical devices.

But those abilities were only available to the patients as long as the brain implants were in place. Brain electrodes, approved by the FDA only in the setting of investigational trials, implanted in all patients, including Dr. Serruya’s, must be removed because the wires that plug into the computer extend through the patient’s skin. Fully implanted wireless intracortical electrodes have not yet been approved for human use.

"Fully implantable BCI implants are currently being developed by a number of companies," says neurosurgeon Robert Rosenwasser , MD, MBA who led the implantation surgery for the patient, along with co-surgeons Ashwini Sharan , MD and Chengyuan Wu , MD. Dr. Rosenwasser is also the chair of the department of Neurological Surgery and president of the Vickie and Jack Farber Institute for Neuroscience at Jefferson Health. "This trial will pave the way for a future in which a patient with permanent disability from stroke can get an implant, train with rehab and artificial intelligence experts to use it, and go home with finer control of a mechanized brace. This study lays the groundwork for that future."

See also  cbd oil for sale new bern nc

"This study will be the first patient implanted with electrodes who can walk and still live semi-independently," says Dr. Serruya. "Although that might seem like an easier task than a fully paralyzed patient, it isn’t. Patients with stroke often develop abnormal movements in order to compensate for what’s lost. We have to overcome this abnormal muscle tone, all while learning to use the implants to control the patient’s arm via the brace."

Dr. Serruya’s team has been working with the patient daily — to train his control of the brain-implant to drive movement of a robotic brace fitted for his weaker arm, as well as how to overcome his abnormal muscle tone. In other words, the patient, like many stroke patients, has an inclination to tighten his left arm across his body, with wrist and fingers clenched. In order to move that weakened hand, the patient needs to both release the tension in his arm – something he does involuntarily – while at the same time think about moving it, through his brain-controlled robotic brace.

Unlike prior BCI studies, which implant and record from electrodes in relatively healthy brains (it’s typically areas in the spine or lower brain that are damaged), Jefferson researchers have implanted electrodes in an area adjacent to the stroke. As a result, the researchers have had to regularly adjust and refine the artificial intelligence algorithms in order to interpret the patient’s intention to move with better fidelity.

"What we’re studying is much more relevant to all of the people who live with disability from stroke. But for that reason, it’s also more challenging," says Dr. Serruya. His team of engineers and rehabilitation experts have been identifying the challenges and differences of using BCI in a patient who is mobile, and devising solutions – work that will inform all future BCI trials for fully implantable and wireless devices.

"We see our patients go home and struggle with simple daily tasks like picking up a cup of coffee or brushing their teeth," says Dr. Rosenwasser. "This approach, which helps restore function, could be a game-changer for stroke patients."

This research was supported by philanthropy from many grateful patients and families over the years.

Can My Dog Have a Stroke?

Like their owners, dogs can be affected by a number of emergency health conditions, including strokes. While strokes are less common in dogs than they are in humans, they are equally as serious. Witnessing your beloved dog having a stroke is a frightening experience — and it’s important to know what to do if this occurs.

What is a Stroke?

According to the National Stroke Association, a stroke occurs when there is a disruption of blood flow to the brain, depriving brain cells of their oxygen supply. This often happens suddenly and without warning. The extent of the damage and its impact on the dog varies depending on the part of the brain affected.

In both humans and dogs, strokes are typically classified as either ischemic or hemorrhagic. “An ischemic stroke occurs when a vessel that supplies blood to a part of the brain becomes blocked, and damage to the brain tissue occurs,” says Dr. Jennifer Coates, a veterinarian who serves on the advisory board for Pet Life Today. “In a hemorrhagic stroke, a vessel in the brain bleeds, which leads to swelling and increased pressure,” she adds. Both types of stroke deprive the brain of blood and oxygen, which causes brain cells to die. Ischemic strokes are more common than hemorrhagic strokes in both people and dogs.

See also  cbd oil for cats ckd

The severity of the stroke depends on how long the brain goes without blood flow. Dr. John McCue, a staff neurologist at the Animal Medical Center in New York City, says that when a dog has a massive, catastrophic stroke in a certain part of the brain, he may not bounce back because essential parts of the brain have been damaged. This can result in a lower quality of life and can sometimes be fatal. But the good news is that a stroke is not always life-altering. Long-term prognosis is good in dogs who are treated early and given the supportive care they need.

Dogs can also experience a Fibrocartilagenous Embolism (FCE), more commonly known as a “spinal stroke.” This occurs when a piece of an intervertebral disc — the cushion that separates each of the dog’s vertebrae — breaks off and causes an obstruction of one of the blood vessels in the spinal cord.

Dr. Gary Richter, owner and medical director of Montclair Veterinary Hospital in Oakland, California, explains that spinal strokes often cause partial or complete paralysis of one or more limbs, depending on where in the spinal cord they occur. He also points out that not all strokes are definitively diagnosed. “It usually takes an MRI to reach a definitive diagnosis — something that isn’t affordable for all pet owners,” he says. “There are probably a lot of ‘mini’ strokes that don’t get diagnosed.”

Signs of a Stroke

The signs of a stroke can be subtle and hard to notice. There are no warning signs to indicate that a stroke is about to happen, and Dr. Coates explains that a dog can go from “seemingly normal” to “severely impaired” very quickly. If left untreated, the problem can worsen in a short period of time. The longer treatment is put off, the greater the chance for permanent neurological damage.

Common signs that your dog might be having a stroke include:

  • Loss of balance
  • Head tilt
  • Pacing, circling, or turning the wrong way when called
  • Abnormal eye movements or facial expressions
  • Impaired vision
  • Loss of control over bladder and bowels
  • Vomiting
  • Collapse, loss of consciousness
  • Acute weakness and/or paralysis in one or more limbs

However, it is important to note that other conditions can cause similar signs. Idiopathic Vestibular Syndrome, in particular, is a common condition of older dogs that can mimic the signs of a stroke. The vestibular system is a delicate array of structures located in the inner ear and brain, which helps dogs maintain balance and coordinate the position of their head, eyes, and legs.

According to Dr. Jerry Klein, Chief Veterinary Officer of the American Kennel Club, any disruption to the vestibular system can cause symptoms such as head tilt, loss of balance, falling or rolling to one side, circling, trouble walking, and abnormal eye movements. Because disruptions to the inner ear can make dogs extremely dizzy, pet owners may also notice signs such as nausea, vomiting, and loss of appetite. Although these signs can be frightening, the good news is that most dogs recover from vestibular disease. Dr. Klein notes that while some may continue to have a head tilt, most dogs regain their sense of balance and do just fine.

See also  best cbd oil for anxiety and pain relief

What Causes a Stroke?

According to Dr. McCue, ischemic and hemorrhagic strokes occur most commonly in older dogs. Spinal strokes are more common in larger, more active breeds.

Strokes also tend to occur more often in dogs that have concurrent health problems. According to the American Animal Hospital Association (AAHA), dogs are at greater risk for having a stroke if they are also affected by other illnesses such as heart disease, diabetes, kidney disease, Cushing’s disease, and Rocky Mountain Spotted Fever, among others. While your dog’s previous medical history may provide some clues, about 50 percent of canine strokes have no specific underlying cause.

Unfortunately, there is no way to prevent a stroke from happening in your dog, but keeping your pet healthy can make a stroke less likely. Regular veterinary checkups are especially important because early detection and treatment of underlying diseases can reduce your dog’s risk of having a stroke.

What Should I Do If My Dog Has a Stroke?

If you suspect your dog has had a stroke, seek veterinary care immediately. If your dog has dark red mucous membranes — in places such as his gums or inner eyelids — this can indicate a lack of oxygenation, according to AAHA. If this occurs, quick treatment is essential to restore proper blood flow. Dr. Richter also advises keeping your dog calm and preventing any injuries that could occur from falling or hitting his head.

Proper diagnosis of a stroke is crucial in order to ensure your dog receives appropriate treatment. Your veterinarian will perform a full physical examination and may recommend additional testing such as blood work, urinalysis, or X-rays to rule out other underlying problems. Because strokes are often related to heart disease, your veterinarian may recommend a full cardiac workup, which can include tests such as an electrocardiogram, chest X-rays, or cardiac ultrasound. In order to definitively diagnose a stroke, an MRI or CAT scan may be recommended to rule out other brain diseases that can cause similar clinical signs.

Will My Dog Recover?

Your dog’s ability to recover from a stroke depends on several factors, including the type of stroke, the severity, any underlying medical conditions, and how quickly your dog received appropriate treatment. Some dogs will begin to show signs of improvement in just a few weeks, while others may need more time. Unfortunately, some dogs will never fully recover from a stroke and, in some cases, the stroke or its associated complications can be fatal. But “with appropriate veterinary care and a dedicated owner,” Dr. Coates says, “many dogs can go on to live happily for quite a long period of time after having a stroke.”