HD Video by Dr Robert D. McMullen about new treatment for stroke
TMS BrainCare
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Stroke Treatment and Rehab Using TMS
Dr. Robert D. McMullen is a psychiatrist who went to Georgetown Medical School and then completed his residency at Columbia Presbyterian. Dr. McMullen has been in practice in New York City and in Mount Kisco for the last 36 years.
Dr. McMullen has been mainly concentrating on using medications for psychiatric disorders, but in this video he talks about treating pain with TMS. TMS stands for transcranial magnetic stimulation and has turned out to work very well for a few psychiatric disorders including OCD, depression, and especially bipolar depression. TMS has also been found to work well for various neurologic disorders including Tourette syndrome, seizure disorder, chronic pain, and stroke rehabilitation. In this video Dr. McMullen talks about the effects of TMS treatment for stroke rehabilitation.
He begins by explaining the after effects of a stroke and also why the recovery and treatment is so difficult. For example, the right arm becomes somewhat paralyzed after a stroke. This happens because there is a lesion on the opposite of the brain, the left side, the area that controls the right arm has had a stroke and as a result a lot of brain cells have died there. As the rehab progresses, the therapist and the patient work on the arm until there is better control of the arm. This is an example of using the plasticity of the brain to improve the function. It also demonstrates that the neurons can change, and that it is possible to take the neurons that are nearby that are normal neurons and they can start function to take care of the arm movements.
A major concern in a stroke is that when the area of a brain has a lesion, then the exact opposite area of the brain becomes hyperactive and this hyperactive area of the brain sends signals through the corpus callosum to the area of the lesion and it sends inhibitory pulses which results in inhibiting the area of the lesion from improving. This in effect means that the brain itself is holding the patient back from the rehab. Essentially, there are two different ways of doing TMS to help in stroke rehab and it is being done at Brooks Rehab and other places.
One way is to do a stimulating treatment in the area of the lesion and this improves the plasticity of the area which in turn increases the growth hormone of the brain or BDNF (brain derived neurotrophic factor). The other way that has been very effective as well is to do the inhibitory treatment over the good area or the opposite side of the brain from the lesion and use an inhibitory 1 pulse per second TMS treatment which helps calm down the area underneath the coil and hence preventing that area from inhibiting the area of the stroke, and that area then is no longer being tonically inhibited and so it can begin to repair itself. What makes this very interesting is the fact that it is a very simple and safe way to improve and help speed up rehabilitation after a stroke.
24 июл 2016
