Globally, the impact of stroke-related impairment is rising. In the UK alone, the economic burden of stroke is estimated at over £9 billion a year and so improving outcomes is an important clinical and scientific goal. In particular, recovery of upper limb function is unacceptably poor and a major contributor to reduced quality-of-life. Our aim is to provide the scientific basis for understanding how to radically improve upper limb recovery after stroke in humans.
He is particularly interested in developing an empirical understanding of cerebral reorganization after stroke and how this will inform treatment strategies for patients with significant motor impairment. He investigates how patterns of brain activity during hand movement change after stroke and as part of normal ageing. Current work is concentrating on further characterisation of these differences using a combination of non-invasive brain imaging tecniques to determine whether imaging and neurophysiological measures will prove useful as biomarkers of the likelihood of responding to various forms of impairment based treatment. This is important because the power of future clinical trials to detect real improvements in function will be greatly enhanced if we are able to stratify patients according to likelihood of response based on strong mechanistic hypotheses.
In 2013, he set up the Queen Square Upper Limb Neurorehabilitation Programme, the only dedicated upper limb rehabilitation facility in the UK. This clinical service offers intensive high dose upper limb neurorehabiltaion to stroke patients and will increasingly become the focus for clinically related research into mechanisms of stroke motor recovery at UCL.