Sensory-parietal cortical stimulation improves motor recovery in severe capsular infarct

J Cereb Blood Flow Metab. 2016 Dec;36(12):2211-2222. doi: 10.1177/0271678X15606136. Epub 2015 Nov 4.

Abstract

The prevalence of subcortical white matter strokes in elderly patients is on the rise, but these patients show mixed responses to conventional rehabilitative interventions. To examine whether cortical electrical stimulation can promote motor recovery after white matter stroke, we delivered stimulation to a small or wide region of sensory-parietal cortex for two weeks in a rodent model of circumscribed subcortical capsular infarct. The sham-operated group (SOG) showed persistent and severe motor impairments together with decreased activation in bilateral sensorimotor cortices and striatum. In contrast, sensory-parietal cortex stimulation significantly improved motor recovery: final recovery levels were 72.9% of prelesion levels in the wide stimulation group (WSG) and 37% of prelesion levels in the small stimulation group (SSG). The microPET imaging showed reversal of cortical diaschisis in both groups: in both hemispheres for the WSG, and in the hemisphere ipsilateral to stimulation in the SSG. In addition, we observed activation of the corpus callosum and subcortical corticostriatal structures after stimulation. The results from the c-Fos mapping study were grossly consistent with the microPET imaging. Sensory-parietal cortex stimulation may therefore be a useful strategy for overcoming the limits of rehabilitative training in patients with severe forms of subcortical capsular infarct.

Keywords: Motor recovery; cortical stimulation; internal capsule; sensory-parietal cortex; stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Brain Infarction / complications*
  • Brain Infarction / therapy
  • Brain Mapping / methods
  • Disease Models, Animal
  • Electric Stimulation*
  • Humans
  • Internal Capsule / physiopathology
  • Motor Activity
  • Motor Disorders / etiology
  • Motor Disorders / therapy*
  • Parietal Lobe*
  • Rats
  • Recovery of Function / physiology*