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Hope for the little ones

Hope for the little ones

Retraining the brain to overcome pediatric stroke

A developing brain holds extraordinary untapped potential—neural networks and pathways form rapidly as children grow and experience the world around them. For victims of neonatal arterial ischemic stroke, a condition that occurs when an infant’s brain loses blood supply, this plasticity offers profound benefits.

“When a stroke affects one side of the brain, survivors often experience muscle weakness and motor difficulties on the opposite side of the body,” says Stuart M. Fraser, MD, who is completing the Child Neurology Residency Program at McGovern Medical School at UTHealth. “I want to help change the story for even the smallest stroke survivors.”

Neonatal arterial ischemic stroke occurs in approximately one out of 1,150 births in the United States due to a blood vessel blockage in the brain. Over time, stroke-related deficits can eventually lead to difficulty walking and other movement challenges as a child grows.

Taking advantage of a growing brain’s flexibility, Fraser is investigating a new method for pediatric stroke rehabilitation with I-ACQUIRE, a study led by Sean I. Savitz, MD. Using constraint-induced movement therapy, they are testing if a cast placed on a child’s unaffected arm will promote greater activity on their weak side.

“By requiring children to use the side of their body affected by the stroke, we believe that they can improve their strength and motor control,” says Fraser. “This has the potential to provide dramatic improvements to their quality of life for years to come.”

As part of the randomized I-ACQUIRE trial, participants up to three years old will be grouped into two different treatment options, receiving either three or six hours of therapy per day for one month. These sessions will involve play activities so that researchers can engage with children doing the things they enjoy—from having fun with new toys to eating meals.

After therapy concludes, the I-ACQUIRE team will conduct follow-up assessments to evaluate how the children progress over a six-month period.

“Stroke in infants is a devastating condition that can lead to a lifetime of disability, and unfortunately, there have been few major advances in pediatric stroke care over the past several decades despite concerted research efforts,” Fraser says. “Through my work with I-ACQUIRE, I hope to help enhance our understanding of pediatric stroke and improve outcomes for patients and their families.”

This study is part of StrokeNet, a multi-institutional initiative launched by the National Institutes of Health to advance stroke treatment, prevention, and recovery. Savitz serves as principal investigator for the UTHealth Regional Coordinating Center in StrokeNet, the largest of the 27 centers established throughout the country.

“There is a lot at stake for this clinical trial,” Savitz says. “These children are just starting out in life, and this research may help them achieve the best possible chances for recovery.”

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