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Exclusive: Woman Can Move Again After a Breakthrough Stroke Treatment

From TIME - August 10, 2017

The first person to receive deep brain stimulation (DBS) for stroke recovery is performing far better than her doctors anticipated.

Two years ago, J udy Slater, a 59 year old in Pulaski, Pennsylvania, was getting out of bed when she had a severe stroke. She fell down and couldnt get back up; the stroke had left her entire left side paralyzed.

With time, Slater was able to regain her ability to walk, but her left arm remained almost entirely immobile, hanging against her side with her elbow stuck tightly at 90 degrees. Her hands and fingers had curled up, and she couldnt extend them on her own. I depended so much on my family, says Slater, who lives with her husband and daughter.

Slaters experience is not unique. In the United States, stroke isthe leading cause of serious long-term disability among Americans, and about half of the 800,000 Americans who have a stroke every year end up disabled. With physical therapy, people can regain some motor function, but more than half of all people with stroke will continue to have severe movement impairments.

After the stroke, Slater couldnt bathe or cook on her own, and she longed for her former independence. Thats why she agreed to become the first person in the world to receive deep brain stimulation (DBS) for stroke recovery: a procedure in which electrodes are implanted in the brain to provide small electric pulses. She is part of a new clinical trial at the Cleveland Clinic aimed at helping people disabled by stroke regain control of their movements.

A medical first

Despite advances in physical therapy and acute treatment of stroke, there are still too many people who live with longterm disabilities, and new technologies are needed, says trial leader Dr. Andre Machado, chairman of the Cleveland Clinic Neurological Institute.

Slater is the first person to receive the treatment. Machado and his team spent more than a decade testing DBS for stroke recovery in animals, and DBS has been used to treat tremors associated with Parkinsons disease, but in that scenario, doctors are trying to get rid of tremors. In the case of stroke, Machado and his team are trying to make movement come backa goal that's considered harder to pull off.

In December 2016, Slater's skull was opened and doctor's surgically implanted electrodes in the area of her brain called the cerebellum. The electrodes provide small pulses that target damaged areas of the brain to help recover movement.The electrodes are attached to a wire that connects them to a small battery pack doctors surgically embedded under the skin in her chest. After she recovered from the initial surgery, Slater started physical therapy, and soon after that, her doctors turned on the device.

Four months after the electrodes were turned on, Slater is doing better than investigators expected. Judy is performing exceptionally well, says Machado. Since weve turned on the device, weve seen an acceleration in her recovery, and we have not yet seen the limit of her gains.

People with severe impairments from stroke can improve with physical therapy alone, but typically the gains are small and then plateau. Machado had originally hoped that Slater would experience improved movement beyond what was expected from physical therapy (DBS is not intended to replace physical therapy, but to make it work better). Machado expected the effects of DBS to eventually reach a similar plateau within about four months, at which point his team would measure how much the procedure contributed to her overall improvement.

An ethical dilemma

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