Stroke

Professor Leeanne Carey

ARC Future Fellow and Head, Neurorehabilitation and Recovery, Stroke Division,
Florey Neurosciences Institutes,
Phone: +61 3 90357088
Email: mailto:lcarey@unimelb.edu.au

The Neuroehabilitation and Recovery research program focuses on investigation of neural plastic mechanisms underlying post-stroke rehabilitation and recovery, identification and measurement of factors that impact on recovery, and development of treatment approaches to facilitate neural plastic changes and better outcomes.  Research outcomes have included development of effective approaches to stroke rehabilitation that are founded on theories of neuroplasticity and learning, and empirically tested for both clinical and neuroanatomical outcomes. Our clinical research focuses on the assessment and treatment of touch sensation and motor function following stroke, and has involved development of novel assessments and science-founded approaches to sensory rehabilitation. This research is enhanced by investigation of the neurobiological mechanisms of recovery post-stroke using neuroimaging techniques and biomarkers. In collaboration with CSIRO, other research groups within the Florey, Melbourne University and clinical sites we commenced the START: STroke imAging, pRevention and Treatment study, a large, multicentre clinical trial. Our focus is on depression, functional outcome and participation and the identification of novel brain imaging and blood markers associated with these outcomes over time. Outcomes from our studies have lead to development of restorative approaches to rehabilitation, and will advance knowledge of underlying mechanism to guide more optimal selection of rehabilitation interventions for individuals after stroke and identification of patients ‘at risk’ of depression through novel brain imaging and biomarkers.

Research highlights for the Neurorehabilitation and Recovery group in 2010 have included publication of the first controlled trial demonstrating an effective approach to sensory rehabilitation based on principles of neural plastic changes in the brain and learning: the SENSe training approach. We are now facilitating dissemination of this training approach into clinical settings through development of multimedia resources to train therapists. We have also published novel findings on the relationship between touch impairment after stroke and brain activation in stroke patients with lesions of subcortical and cortical somatosensory regions. Positive findings from these studies highlight the importance of investigating functional and structural changes in brain networks, leading to our current program of research ‘Improved targeting of effective sensorimotor rehabilitation based on viable brain networks.’ We would like to congratulate Dr Brian Hoare on receiving his doctorate for the program of research ‘An evaluation of occupational therapy and modified constraint induced movement therapy following Botulinum toxin-A injection in the upper limb in children with spastic hemiplegic cerebral palsy’. Dr Hoare has received multiple awards during his candidature. Congratulations also to Mary Mastos who received her Master’s qualification with the research project ‘Occupation-based outcomes associated with sensory retraining post stroke.’ Other PhD students have also made and continue to make substantial contributions to research in the field, as reflected in publications listed below. Finally Professor Carey was a finalist in the BrainLink Women of Achievement Award in recognition of her community and research-based contributions to brain injury.
 

View all major research projects here>>

Staff
Leeanne Carey, BAppSc(OT), PhD
Gemma Lamp, BSc(Hons)
Ayla Barutchu, BSc (Hons), PhD
Mary Mastos, BOT,
Tamara Tse, BOT,
Bonnie Alexander, BSc, PGDipPsych
David Carey.

Honorary Associates
Rudiger Seitz, Honorary Professor
Thomas Matyas, BA (Hons), PhD
Sheila Crewther, BScHons, MSc, DipEd, BOptom, MAPrelimNeuropsych, PhD(Caltech), MAPS
Jacinta Douglas, Honorary Professor
Aina Puce, Honorary Professor
Maria Gavrilescue, Collaborator, FNI
Jannette Blennerhassett, Honorary Research Fellow
Carolyn Baum, Honorary Professor
Assia Jaillard, Honorary Fellow

Students
Brian Hoare, PhD Candidate
Isobel Hubbard, PhD Candidate
Michaela Pascoe, PhD Candidate
Tamara Tse, PhD Candidate
Kate Noonan, Clinical Doctorate
Louise Bannister, Clinical Doctorate
David McArdle, Masters Candidate
Johanne Walker, Masters Candidate
Mary Mastos, Masters Candidate
Yvonne Mak, Honours Candidate
Anne Marie Tan, Honours Candidate

Publications
Carey, L.M., Macdonell, R. Matyas, D. SENSe: Study of the Effectiveness of Neurorehabilitation on Sensation. A randomized controlled trial. Neurorehabilitation and Neural Repair. 2011; 25 (4), 304-313.

Carey, L.M., Abbott, D.F., Harvey, M.R., Puce, A., Seitz, R.J., Donnan, G.A. The Relationship between Touch Impairment and Brain Activation After Lesions of Subcortical and Cortical Somatosensory Regions. Neurorehabilitation and Neural Repair. 2011; 25 (5), 443-457.

Carey, L.M., Matyas, T.A. Frequency of Discriminative Sensory Loss in the Hand after Stroke. Journal of Rehabilitation Medicine. 2011; 43 (3), 257-263.

Pascoe, M., Crewther, D., Carey, L., Crewther, S. Inflammation and Depression: Why Post Stroke Depression May be the Norm and not the Exception. International Journal of Stroke. 2011; 6 (2), 128-135. PMID: 21371275

Spitzer, J., Tse, T., Baum, C., Carey, L.M. (2011) Mild cognitive impairment impacts on activity participation post-stroke in an Australian cohort. Occupational Therapy Journal of Research: Occupational, Participation and Health: Special focus: Cognition and Executive Function. 31 (No 1 suppl), S8-15.

Carey, L.M. Neuroscience Makes Sense for Occupational Therapy. Viewpoint. Australian Occupational Therapy Journal. 2010; 57 (3), 197-199.

Carey, L.M., Blennerhassett, J., Matyas, T. Evidence for the retraining of sensation after stroke remains limited. Critically Appraised Papers. Commentary. Australian Occupational Therapy Journal. 2010; 57, 200-202.

Blennerhassett, J.M., Avery, R.M., Carey, L.M. The test-retest reliability and responsiveness to change for the Hand Function Survey during stroke rehabilitation. Australian Occupational Therapy Journal. 2010; 57, 355-446.

Hoare, B., Imms, C., Rawicki, H. B., Carey, L. Modified constraint-induced movement therapy or bimanual occupational therapy following injection of Botulinum toxin-A to improve bimanual performance in children with hemiplegic cerebral palsy: A randomised controlled trial methods paper. BMC Neurology 2010, 10:58.

Hoare, B., Wallen, M., Imms, C., Villanueva, E., Rawicki, H. B., Carey, L. Botulinum toxin A as an adjunct to treatment in the management of the upper limb in children with spastic hemiplegic cerebral palsy (Cochrane Review): Update. In: The Cochrane Library, Issue 1 2010. Chichester, UK: John Wiley & Sons, Ltd.

Book chapters
Carey, L.M. (2010) Forward, In Lyons, W. Left of Tomorrow. ISBN: 9781921642456

Carey, L.M. & Baum, C. (In press) Occupational Therapy. In Azari, N.P. (ed). Encyclopaedia of Sciences and Religions. Springer Verlag. Heidelberg, Germany ISBN: 978-1-4020-8264-1

Puce, A. & Carey, L. (2010). Somatosensory function. In Weiner, I.B. & Craighead, WE, Nemeroff, CB (Eds) The Corsini Encyclopedia of Psychology. 4th ed. New York. John Wiley & Sons, Inc. http://mrw.interscience.wiley.com/emrw/9780470479216/home

Other publications
Carey, L.M. (2011) SENSe: An Evidence Based Approach to Sensory Rehabilitation. LaTrobe University (DVD)

Carey, L.M. (2011) Assessment of Body Sensations after Stroke. LaTrobe University (DVD)

Carey, LM (2010). Evidence based