TY  - BOOK
AU  - Barth, Jessica
AU  - Brady, Kathaleen
AU  - Dromerick, Alexander W
AU  - Edwardson, Matthew
AU  - Geed, Shashwati
AU  - Giannetti, Margot L
AU  - Mitchell, Abigail
AU  - Newport, Elissa L
TI  - Critical Period After Stroke Study (CPASS): A phase II clinical trial testing an optimal time for motor recovery after stroke in humans
SN  - 0027-8424
PY  - 2021///
KW  - *Motor Activity/ph [Physiology]
KW  - *Recovery of Function
KW  - *Stroke Rehabilitation/mt [Methods]
KW  - *Stroke/th [Therapy]
KW  - Aged
KW  - Case-Control Studies
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Prognosis
KW  - Prospective Studies
KW  - MedStar National Rehabilitation Network
KW  - Journal Article
KW  - Research Support, N.I.H., Extramural
KW  - Research Support, Non-U.S. Gov't
N2  - Restoration of human brain function after injury is a signal challenge for translational neuroscience. Rodent stroke recovery studies identify an optimal or sensitive period for intensive motor training after stroke: near-full recovery is attained if task-specific motor training occurs during this sensitive window. We extended these findings to adult humans with stroke in a randomized controlled trial applying the essential elements of rodent motor training paradigms to humans. Stroke patients were adaptively randomized to begin 20 extra hours of self-selected, task-specific motor therapy at <=30 d (acute), 2 to 3 mo (subacute), or >=6 mo (chronic) after stroke, compared with controls receiving standard motor rehabilitation. Upper extremity (UE) impairment assessed by the Action Research Arm Test (ARAT) was measured at up to five time points. The primary outcome measure was ARAT recovery over 1 y after stroke. By 1 y we found significantly increased UE motor function in the subacute group compared with controls (ARAT difference = +6.87 +/- 2.63, P = 0.009). The acute group compared with controls showed smaller but significant improvement (ARAT difference = +5.25 +/- 2.59 points, P = 0.043). The chronic group showed no significant improvement compared with controls (ARAT = +2.41 +/- 2.25, P = 0.29). Thus task-specific motor intervention was most effective within the first 2 to 3 mo after stroke. The similarity to rodent model treatment outcomes suggests that other rodent findings may be translatable to human brain recovery. These results provide empirical evidence of a sensitive period for motor recovery in humans. Copyright (c) 2021 the Author(s). Published by PNAS
UR  - https://dx.doi.org/10.1073/pnas.2026676118
ER  -