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Rebalancing the brain:<br/>Guiding brain recovery after stroke

Final Report Summary - BRAINBALANCE (Rebalancing the brain:Guiding brain recovery after stroke)

Patients with brain lesions undergo enormous suffering, and account for 35% of health care costs in Europe. Paralleling this dramatic situation, the average age of patients suffering from stroke is continuously decreasing. Surprisingly, there currently is no scientifically informed way to assist the recovery of these patients. In the ERC-funded project BRAINBALANCE, we designed a cutting edge methodological approach that allows to non-invasively induce ‘virtual’ brain lesions in healthy volunteers (using TMS), and study compensation processes while they happen in the brain under controlled experimental conditions with excellent spatial (using fMRI) and temporal (using EEG) resolution. Our approach involves combining simultaneous fMRI, EEG, and TMS with home-grown multivariate analyses that permit predicting the effects of virtual brain lesions at a level of detail that opens up the perspective of effective therapeutic interventions. We first explored the brain network involved in balanced bodily and spatial awareness in healthy volunteers, and then used non-invasive magnetic brain stimulation (TMS) to unravel which parts of the so-called dorsal attention network are functionally necessary for intact spatial cognition performances. We then could move forward to also study compensatory brain processes occurring after experimentally-induced local brain activity disruptions, revealing the exact spatio-temporal activity pattern that allows the brain to recover from “virtual lesions” thanks to processes of functional reorganisation and brain plasticity. Finally, we were able to translate these findings into clinical application and develop an innovative noninvasive brain stimulation protocol designed to guide and promote recovery in patients suffering from cognitive deficits after unilateral stroke. Our clinical proof-of-concept study indicates that noninvasive brain stimulation based on spatiotemporal parameters derived from fundamental brain research may represent a new and powerful tool for the rehabilitative armamentarium of stroke.