Improved Functional Outcome After Peripheral Nerve Stimulation of the Impaired Forelimb Post-stroke
Lack of blood flow to the brain, i.e., ischemic stroke, results in loss of nerve cells and therefore loss of function in the effected brain regions. There is no effective treatment to improve lost function except restoring blood flow within the first several hours. Rehabilitation strategies are wide...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.610434/full |
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| author | Shih-Yen Tsai Jennifer A. Schreiber Jennifer A. Schreiber Natalie S. Adamczyk Joanna Y. Wu Son T. Ton Ryan C. Hofler James S. Walter Timothy E. O'Brien Gwendolyn L. Kartje Gwendolyn L. Kartje Russ P. Nockels |
| author_facet | Shih-Yen Tsai Jennifer A. Schreiber Jennifer A. Schreiber Natalie S. Adamczyk Joanna Y. Wu Son T. Ton Ryan C. Hofler James S. Walter Timothy E. O'Brien Gwendolyn L. Kartje Gwendolyn L. Kartje Russ P. Nockels |
| author_sort | Shih-Yen Tsai |
| collection | DOAJ |
| description | Lack of blood flow to the brain, i.e., ischemic stroke, results in loss of nerve cells and therefore loss of function in the effected brain regions. There is no effective treatment to improve lost function except restoring blood flow within the first several hours. Rehabilitation strategies are widely used with limited success. The purpose of this study was to examine the effect of electrical stimulation on the impaired upper extremity to improve functional recovery after stroke. We developed a rodent model using an electrode cuff implant onto a single peripheral nerve (median nerve) of the paretic forelimb and applied daily electrical stimulation. The skilled forelimb reaching test was used to evaluate functional outcome after stroke and electrical stimulation. Anterograde axonal tracing from layer V pyramidal neurons with biotinylated dextran amine was done to evaluate the formation of new neuronal connections from the contralesional cortex to the deafferented spinal cord. Rats receiving electrical stimulation on the median nerve showed significant improvement in the skilled forelimb reaching test in comparison with stroke only and stroke with sham stimulation. Rats that received electrical stimulation also exhibited significant improvement in the latency to initiate adhesive removal from the impaired forelimb, indicating better sensory recovery. Furthermore, axonal tracing analysis showed a significant higher midline fiber crossing index in the cervical spinal cord of rats receiving electrical stimulation. Our results indicate that direct peripheral nerve stimulation leads to improved sensorimotor recovery in the stroke-impaired forelimb, and may be a useful approach to improve post-stroke deficits in human patients. |
| first_indexed | 2024-12-20T12:35:40Z |
| format | Article |
| id | doaj.art-25f460760e2d411b99f8d727ba987f08 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-20T12:35:40Z |
| publishDate | 2021-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-25f460760e2d411b99f8d727ba987f082022-12-21T19:40:37ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-04-011210.3389/fneur.2021.610434610434Improved Functional Outcome After Peripheral Nerve Stimulation of the Impaired Forelimb Post-strokeShih-Yen Tsai0Jennifer A. Schreiber1Jennifer A. Schreiber2Natalie S. Adamczyk3Joanna Y. Wu4Son T. Ton5Ryan C. Hofler6James S. Walter7Timothy E. O'Brien8Gwendolyn L. Kartje9Gwendolyn L. Kartje10Russ P. Nockels11Edward Hines Jr. Veteran Affairs Hospital, Hines, IL, United StatesEdward Hines Jr. Veteran Affairs Hospital, Hines, IL, United StatesDepartment of Neurological Surgery, Loyola University Medical Center, Maywood, IL, United StatesEdward Hines Jr. Veteran Affairs Hospital, Hines, IL, United StatesEdward Hines Jr. Veteran Affairs Hospital, Hines, IL, United StatesEdward Hines Jr. Veteran Affairs Hospital, Hines, IL, United StatesDepartment of Neurological Surgery, Loyola University Medical Center, Maywood, IL, United StatesEdward Hines Jr. Veteran Affairs Hospital, Hines, IL, United StatesDepartment of Mathematics and Statistics and Institute of Environmental Sustainability, Loyola University Chicago, Chicago, IL, United StatesEdward Hines Jr. Veteran Affairs Hospital, Hines, IL, United StatesDepartment of Molecular Pharmacology and Neuroscience, Loyola University Chicago Health Science Division, Chicago, IL, United StatesDepartment of Neurological Surgery, Loyola University Medical Center, Maywood, IL, United StatesLack of blood flow to the brain, i.e., ischemic stroke, results in loss of nerve cells and therefore loss of function in the effected brain regions. There is no effective treatment to improve lost function except restoring blood flow within the first several hours. Rehabilitation strategies are widely used with limited success. The purpose of this study was to examine the effect of electrical stimulation on the impaired upper extremity to improve functional recovery after stroke. We developed a rodent model using an electrode cuff implant onto a single peripheral nerve (median nerve) of the paretic forelimb and applied daily electrical stimulation. The skilled forelimb reaching test was used to evaluate functional outcome after stroke and electrical stimulation. Anterograde axonal tracing from layer V pyramidal neurons with biotinylated dextran amine was done to evaluate the formation of new neuronal connections from the contralesional cortex to the deafferented spinal cord. Rats receiving electrical stimulation on the median nerve showed significant improvement in the skilled forelimb reaching test in comparison with stroke only and stroke with sham stimulation. Rats that received electrical stimulation also exhibited significant improvement in the latency to initiate adhesive removal from the impaired forelimb, indicating better sensory recovery. Furthermore, axonal tracing analysis showed a significant higher midline fiber crossing index in the cervical spinal cord of rats receiving electrical stimulation. Our results indicate that direct peripheral nerve stimulation leads to improved sensorimotor recovery in the stroke-impaired forelimb, and may be a useful approach to improve post-stroke deficits in human patients.https://www.frontiersin.org/articles/10.3389/fneur.2021.610434/fullstrokerecoveryplasticitymiddle cerebral artery occlusionelectrical stimulationimplantable device |
| spellingShingle | Shih-Yen Tsai Jennifer A. Schreiber Jennifer A. Schreiber Natalie S. Adamczyk Joanna Y. Wu Son T. Ton Ryan C. Hofler James S. Walter Timothy E. O'Brien Gwendolyn L. Kartje Gwendolyn L. Kartje Russ P. Nockels Improved Functional Outcome After Peripheral Nerve Stimulation of the Impaired Forelimb Post-stroke Frontiers in Neurology stroke recovery plasticity middle cerebral artery occlusion electrical stimulation implantable device |
| title | Improved Functional Outcome After Peripheral Nerve Stimulation of the Impaired Forelimb Post-stroke |
| title_full | Improved Functional Outcome After Peripheral Nerve Stimulation of the Impaired Forelimb Post-stroke |
| title_fullStr | Improved Functional Outcome After Peripheral Nerve Stimulation of the Impaired Forelimb Post-stroke |
| title_full_unstemmed | Improved Functional Outcome After Peripheral Nerve Stimulation of the Impaired Forelimb Post-stroke |
| title_short | Improved Functional Outcome After Peripheral Nerve Stimulation of the Impaired Forelimb Post-stroke |
| title_sort | improved functional outcome after peripheral nerve stimulation of the impaired forelimb post stroke |
| topic | stroke recovery plasticity middle cerebral artery occlusion electrical stimulation implantable device |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.610434/full |
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