Day 2 :
Paracelsus Medical University Salzburg, Austria
Time : 10:00-10:40
Stefan Golaszewski was born 1964 in Vienna where he studied Technical Physics and Medicine. From 1995 to 2001 he worked as Neurologist at the University Innsbruck where he focused on clinical applications of functional Magnetic Resonance Imaging (fMRI). From 2001 to 2002 he worked at the Medical University Graz. Since 2005 he works as associate Professor at the Department of Neurology at the Paracelsus Medical University (PMU) Salzburg in Austria and focuses on the investigation of cortical reorganization after stroke. Since 2010 he is medical head of the Neuroscience Institute of the PMU. He published 120 papers in international peer-reviewed journals.
Restoring sensorimotor, neuropsychological or cognitive functions after a stroke is usually unsatisfactory. At the same time increases the stroke frequency, and the number of those who survive such an event and therefore have high hopes for the rehabilitation treatment increases considerably in recent years. The talk provides an overview of new approaches in stroke rehabilitation that are currently in the experimental stage or at the edge of daily clinical neurorehabilitation including also pharmacologic agents for neuroenhancement.\\r\\nFirstly, the lecture gives a comprehensive overview about the methods of peripheral electrical stimulation for enhancing corticospinal excitability in stroke patients to improve sensorimotor function of the upper and the lower extremity. Different levels of stimulation and different stimulation protocols in combination with motor training are discussed. A special method for peripheral electrical stimulation with a mesh glove is presented. Results of single and paired-pulse transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) are presented to follow corticospinal excitability changes and to assess cortical brain reorganization changes after a treatment period with the mesh glove. Effects of mesh glove stimulation are compared to a control group receiving sham stimulation. A program with mesh glove stimulation to raise sensorimotor cortical excitability in the lesioned cortex applied before a physiotherapeutic training to raise effectiveness of a subsequent motor training is presented. In addition, peripheral vibration for enhancing corticospinal excitability and its neuromodulatory potential in stroke patients will be discussed.\\r\\nThe talk will further concern methods for central sensorimotor, neuropsychological and cognitive stimulation by transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) for inhibition and facilitation of lesioned and unlesioned brain structures for promoting cortical reorganisation after stroke.\\r\\nAnother topic of the talk will be functional electrical stimulation (FES)-assisted active cycling in comparison with active cycling without FES concerning walking and balance in stroke patients. The results of a randomized controlled trail that was recently published in the Archives of Physical Medicine and Rehabilitation will be summarized and potential applications of FES in stroke rehabilitation will be discussed.\\r\\nFinally, the talk will deal with targets of a neuropharmacologic enhancement of sensorimotor, neuropsychological and cognitive functions in stroke patients to promote recovery and will present pharmacologic agents that hold promise for a future application in daily neurorehabilitation and will discuss its side effects and potential risks.\\r\\n
Lund University, Sweden
Time : 10:40-11:10
Saema Ansar has completed her PhD at Lund University, Sweden in 2007. After her two post-doctoral trainings at Department of Neurology at Heidelberg University,\\r\\nGermany and at Glostrup Research Institute, Copenhagen University, Denmark, she has been working as senior researcher at Department of Clinical Science of Lund\\r\\nUniversity. She has well-recognized expertise in the fi eld of stroke, vascular research, pharmacology, drug delivery and advanced imaging technology such as MRI. She\\r\\nhas supervised more than 15 graduate and undergraduate students and has published more than 20 papers in reputed journals.
Substantial eff orts have been made over the last three decades to understand the biochemical mechanisms involved in\\r\\nischemic brain damage and to develop potential remedies to protect the brain aft er stroke. However, although more than\\r\\n1,000 experimental neuroprotective agents and procedures have been tried, they have all failed in major clinical trials. Th us, it\\r\\nis necessary to reconsider the premises upon which these failed treatments were developed and fi nd novel ways to understand\\r\\nand treat acute cerebral ischemia. Stroke is primarily a vascular disease, with devastating consequences for brain tissue/neurons.\\r\\nHowever, the primary focus for much of stroke research has hitherto been on the protection of neurons. Our research group has\\r\\ntaken a diff erent approach: we have focused instead on the cerebral vasculature and the changes that occur in this tissue in the days\\r\\nfollowing a stroke. Th is work is driven by the basic consideration that without properly regulated blood circulation in the brain,\\r\\nany attempt at neuroprotection will have a low chance of success. Our research group is the fi rst to discover the inherent capability\\r\\nof cerebral vessels to increase the expression and function of vasoconstrictor receptors in the smooth muscle cells as a response to\\r\\ncerebral ischemia. We recently discovered that inhibition of the MEK signaling pathway in the cerebral vasculature improves acute\\r\\noutcome in all types of experimental stroke. Th ese exciting initial fi ndings are propelling our current research program.