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Research Study of Motor Learning and Acute Recovery Time Course in Stroke

SMARTS is a series of studies conducted by DR. John Krakauer at Johns Hopkins exploring how the brain changes over the first year following a stroke. Dr. Krakauer is using several non-invasive techniques, including MRI, transcranial magnetic stimulation and measures of arm movement in order to learn more about how individuals recover from stroke. It is hoped that this information will help predict recovery and help researchers understand how changes in the brain relate to the performance of movement. This study is being conducted at Johns Hopkins Hospital and the Kennedy Krieger Institute. BIOS (Brain Injury Outcomes Service) is providing trial coordination.

The pilot study, SMARTS-1, was conducted to evaluate and quantify the biologic factors that are associated with the natural history of recovery over stroke, and to investigate the relationship between motor learning capacity and functional recovery over the course of 12 months post stroke.

In order to learn about recovery from stroke, noninvasive techniques including MRI, transcranial magnetic stimulation, cognitive testing, and a variety of methods of measurement of the ability to move arms was tested at  5 time-points over a year following stroke.

This study was an observational study, conducted for the past 2 years, enrolling participants within 4-6 weeks following an acute stroke. 

The Hopkins researchers had considerable success with the 16 patients enrolled—10 have completed the year of testing thus far. This was a multi-center study, with additional patients enrolled at Columbia University, and in Zurich Switzerland. 

SMARTS 2 will open for recruitment this summer. The premise of the new trial is that during the early period, when most of a patient's spontaneous motor recovery occurs, training will have the greatest effects.