Electrical forepaw stimulation during reversible forebrain ischemia decreases infarct volume.
OBJECTIVE
Functional stimulation is accompanied by increases in regional cerebral blood flow which exceed metabolic demands under normal circumstances, but it is unknown whether functional stimulation is beneficial or detrimental in the setting of acute ischemia. The aim of this study was to determine the effect of forepaw stimulation during temporary focal ischemia on neurological and tissue outcome in a rat model of reversible focal forebrain ischemia.


METHODS
Sprague-Dawley rats were prepared for temporary occlusion of the right middle cerebral artery (MCA) using the filament model. Cerebral blood flow in the MCA territory was continuously monitored with a laser-Doppler flowmeter. Subdermal electrodes were inserted into the dorsal forepaw to stimulate either the forepaw ipsilateral or contralateral to the occlusion starting 1 minute into ischemia and continuing throughout the ischemic period. A neurological evaluation was undertaken after 24 hours of reperfusion, and animals were then euthanized and brain slices stained with 2,3,5-triphenyltetrazolium chloride. Cortical and striatal damage was measured separately.


RESULTS
The cortical and striatal infarct volumes were both significantly reduced in the contralateral stimulated group compared with the ipsilateral stimulated group (48% total reduction). There were no statistically significant differences in the neurobehavioral scores between the 2 groups, or in the laser-Doppler flow measurements from the MCA core.


CONCLUSIONS
Functional stimulation of ischemic tissue may decrease tissue damage and improve outcome from stroke. Although the precise mechanism of this effect remains to be determined, functional stimulation could readily be translated to clinical practice.
Burnett
Mark G
MG
Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Shimazu
Tomokazu
T
Szabados
Tamas
T
Muramatsu
Hiromi
H
Detre
John A
JA
Greenberg
Joel H
JH
D000818:Animals; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D002560:Cerebrovascular Circulation; D004558:Electric Stimulation; D004599:Electric Stimulation Therapy; D066298:In Vitro Techniques; D020768:Middle Cerebral Artery / Q000473:pathology; D051381:Rats; D017207:Rats, Sprague-Dawley; D017585:Ultrasonography, Doppler, Transcranial