Fitness Files: We’re missing the early potential for brain recovery after stroke

What if I told you that after a stroke, the human brain’s growth potential can be compared to that of a baby’s? Or that a video game might help recover movement in an arm partially paralyzed by stroke?

“Stroke of Insight” and “One Hundred Names for Love” are both convincing memoirs of stroke recovery. I was also interested in Karen Russell’s New Yorker article from Nov. 13, “Helping Hand,” which details the brain’s astounding potential for adaptability after a stroke.

Russell says, “Stroke-induced injury to the brain may have a silver lining.… The tissue death that results from stroke appears to trigger a self-repair program in the brain. For between one and three months, the brain enters a growth phase … that in some ways resembles the brain environment of infancy and early childhood.… Networks of brain cells begin to reroute around the stroke lesion, and neurons adjacent to the lesion start to take over some of the dead cells’ functions.”

During this early period of brain potential, the best that health insurance provides is limited rehabilitation, with the weakened arm making about 32 reaches per session. Further ignoring the brain’s early adaptation possibilities, rehab emphasizes use of the stronger side of the body.

Dr. John Krakauer, barrier-breaking neurologist at John’s Hopkins, says the therapy I’ve just described “has no impact” on a patient’s recovery. He seeks to increase the number of practices per session to something like 400 to 500.

Krakauer had sinks ripped out of his lab at Johns Hopkins to install sophisticated game design computers and a machine shop and make way for a 3D printer. In his lab, a team of Pixar-grade video game designers created “Bandit’s Shark Showdown.”

Bandit, a lovable dolphin, moves in a graceful underwater ballet against a stunning indigo blue sea. Bandit snaps up mackerel, crunching with gusto, or fends off life-threading shark attacks with a bolt from its tail. The “catch” is that a stroke victim moves his or her bad arm to feed and protect the sparkly eyed dolphin.

“I was so wrapped up in the game,” G., a 53-year-old stroke patient, is quoted as saying in the article. “I wasn’t noticing [the robotic chair assisting his arm movement.] Tearing up, he said he’d “fallen through the cracks.” His insurance discontinued rehab sessions “in spite of his eagerness to continue.” He didn’t want to be “something broken,” so he turned to the video game for help to “cope with what he had left.”

With patients like G, who is past the critical early period, “the game may provide an unexpected psychological benefit — ‘motor psychotherapy,’” seeing that they can use their semi-paralyzed arm again to achieve something.

Krakauer’s brilliant video-game designers are committed to helping people like G. But they created Bandit to sell to the public. The Princeton lab seeks to merge advanced university research with a profit-making venture, thus retaining talented game designers and financing further research.

Current medical advances keep more people alive but ignore the potential for change, so “four years after a stroke, 80% of patients report … they have difficulty with bathing, cooking and driving,” the article says. Krakauer’s introduction of a beautiful, motivating video game comes from his discovery that the motor system waits for us to marshall ways toward stroke victims’ independence.

In “Stroke of Insight,” Dr. Jill Bolte Taylor, a Harvard-trained neuroscientist, observes her own massive left-hemisphere stroke as it happens, then takes the reader though recovery and return to advanced brain research. Diane Ackerman’s “One Hundred Names for Love” is an intensely personal account of her writer husband’s stroke and his return to writing. Both recoveries were driven by herculean efforts of family.

If a patient has prompt therapy with Bandit, he or she can start recovery, somewhat more independently, and take advantage of the brain’s early growth phase.

I’m rooting for a playful dolphin as a tireless therapist dedicated to rewiring a ready brain.

Newport Beach resident CARRIE LUGER SLAYBACK, since turning 70, has run the Los Angeles Marathon and the Carlsbad Marathon.