Broken Movement. The Neurobiology of Motor Recovery After Stroke

An account of the neurobiology of motor recovery in the arm and hand after stroke by two experts in the field.

Stroke is a leading cause of disability in adults and recovery is often difficult, with existing rehabilitation therapies largely ineffective. In Broken Movement, John Krakauer and S. Thomas Carmichael, both experts in the field, provide an account of the neurobiology of motor recovery in the arm and hand after stroke. They cover topics that range from behavior to physiology to cellular and molecular biology. Broken Movement is the only accessible single-volume work that covers motor control and motor learning as they apply to stroke recovery and combines them with motor cortical physiology and molecular biology. The authors cast a critical eye at current frameworks and practices, offer new recommendations for promoting recovery, and propose new research directions for the study of brain repair.

Krakauer and Carmichael discuss such subjects as the behavioral phenotype of hand and arm paresis in human and non-human primates; the physiology and anatomy of the motor system after stroke; mechanisms of spontaneous recovery; the time course of early recovery; the challenges of chronic stroke; and pharmacological and stem cell therapies. They argue for a new approach in which patients are subjected to higher doses and intensities of rehabilitation in a more dynamic and enriching environment early after stroke. Finally they review the potential of four areas to improve motor recovery: video gaming and virtual reality, invasive brain stimulation, re-opening the sensitive period after stroke, and the application of precision medicine.

John W. Krakauer

John W. Krakauer is John C. Malone Professor and Professor of Neurology, Neuroscience, and Physical Medicine and Rehabilitation at the Johns Hopkins University School of Medicine.

S. Thomas Carmichael

S. Thomas Carmichael is Professor and Chair and Frances Stark Endowed Chair in the Department of Neurology at the David Geffen School of Medicine at the University of California, Los Angeles, and Codirector of UCLA's Broad Stem Cell Center.

Reviews

My hope is that Broken Movement leads the brightest and best to be impressed with what we already know about stroke recovery, be curious as to why clinical outcomes are still poor and then join the cause to make things better. - Brain

Endorsements

It is an enormous pleasure to read such a deeply researched and meticulous monograph by two outstanding scientists. At last we get informed, considered opinions that are combined with a unified intellectual thread, rather than the usual multi-authored catechism that intones the literature without questioning the content. It will irritate and delight in equal measure, but is never dull.

John Rothwell

Professor of Human Neurophysiology, University College London Institute of Neurology

This elegant book provides a critical re-examination of stroke recovery, and by providing a mechanistic understanding sets the stage for new and more effective therapies.

Daniel Wolpert

Royal Society Research Professor; Professor of Engineering, Department of Engineering, University of Cambridge