From Biology to Better Therapy
Researching how to make rehabilitation more effective for stroke survivors.
Stroke is a leading cause of adult disability, and recovery of arm and hand function remains one of the greatest challenges. Our lab’s research centers on a powerful idea: the brain may have a time‑sensitive window for heightened neuroplasticity, a critical period, in the first months after stroke.
In our previous trial (the Critical Periods After Stroke Study, CPASS), we showed that just 20 hours of additional, structured training provided in this window led to significant improvements in upper‑limb function compared to usual care. Importantly, patients who received the exact same training later at six months after stroke did not show the same benefit. This was the first clinical evidence that the timing of therapy is crucial, confirming decades of experimental findings in neuroscience.
The trial results do not mean that arm-hand function will not recover at a later time "outside the critical period" - post stroke recovery happens any time we provide dedicated intensive neurorehabilitaiton. The study just shows that these gains might get amplified with therapy during the critical period, because there is something different going on in the brain during the critical period.
The trial results do not mean that arm-hand function will not recover at a later time "outside the critical period" - post stroke recovery happens any time we provide dedicated intensive neurorehabilitaiton. The study just shows that these gains might get amplified with therapy during the critical period, because there is something different going on in the brain during the critical period.
Our current project digs deeper into the mechanisms behind this critical period. We are investigating how the brain’s balance between excitation and inhibition temporarily shifts after stroke, creating conditions that make it especially receptive to therapy. In plain terms, we want to understand why the brain “lets its guard down” for a short while and how neurorehabilitation can take advantage of this.
Why does this matter? If we can pinpoint the biological changes that drive recovery, we could design treatments that extend or reopen critical periods, making therapy more effective even beyond the early months. That could mean shorter disability, more independence, and better quality of life for millions of stroke survivors.
We approach this work with two guiding principles:
- Scientific rigor using validated measures of brain function (TMS, EEG, MR spectroscopy) and real‑world behavior captured via wrist-worn accelerometers.
- Translational impact is important for our lab. We ensure discoveries in the lab lead to better therapies in clinics and communities.
Our vision is a future where rehabilitation is timed and tailored to each individual’s brain state, maximizing the chance of recovery and minimizing lifelong disability.