title: Chronic electrical stimulation of the contralesional lateral cerebellar nucleus enhances recovery of motor function after cerebral ischemia in rats.
abstract: Novel neurorehabilitative strategies are needed to improve motor outcomes following stroke. Based on the disynaptic excitatory projections of the dentatothalamocortical pathway to the motor cortex as well as to anterior and posterior cortical areas, we hypothesize that chronic electrical stimulation of the contralesional dentate (lateral cerebellar) nucleus output can enhance motor recovery after ischemia via augmentation of perilesional cortical excitability. Seventy-five Wistar rats were pre-trained in the Montoya staircase task and subsequently underwent left cerebral ischemia with the 3-vessel occlusion model. All survivors underwent stereotactic right lateral cerebellar nucleus (LCN) implantation of bipolar electrodes. Rats were then randomized to 4 groups: LCN stimulation at 10 pps, 20 pps, 50 pps or sham stimulation, which was delivered for a period of 6 weeks. Performance on the Montoya staircase task was re-assessed over the last 4 weeks of the stimulation period. On the right (contralesional) side, motor performance of the groups undergoing sham, 10 pps, 20 pps and 50 pps stimulation was, respectively, 2.5+/-2.7; 2.1+/-2.5; 6.0+/-3.9 (p<0.01) and 4.5+/-3.5 pellets. There was no difference on the left (ipsilesional) side motor performance among the sham or stimulation groups, varying from 15.9+/-6.7 to 17.2+/-2.1 pellets. We conclude that contralesional chronic electrical stimulation of the lateral cerebellar nucleus at 20 pps but not at 10 or 50 pps improves motor recovery in rats following ischemic strokes. This effect is likely to be mediated by increased perilesional cortical excitability via chronic activation of the dentatothalamocortical pathway.
authors.affiliation: Center for Neurological Restoration, Department of Neurosurgery, Cleveland Clinic, Cleveland, OH 44195, USA. machada@ccf.org
authors.forename: Andre G
authors.initials: AG
authors.lastname: Machado
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Baker
authors.forename: Daniel
authors.initials: D
authors.lastname: Schuster
authors.forename: Robert S
authors.initials: RS
authors.lastname: Butler
authors.forename: Ali
authors.initials: A
authors.lastname: Rezai
mesh_terms: D000818:Animals; D002545:Brain Ischemia / Q000150:complications*; D002529:Cerebellar Nuclei / Q000502:physiology*; D046690:Deep Brain Stimulation / Q000379:methods; D004567:Electrodes, Implanted; D009043:Motor Activity / Q000502:physiology; D009069:Movement Disorders / Q000209:etiology* / Q000628:therapy*; D011214:Practice, Psychological; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D017208:Rats, Wistar; D020127:Recovery of Function; D020521:Stroke / Q000150:complications; D013647:Task Performance and Analysis; D013997:Time Factors; D016896:Treatment Outcome