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Cai G, Xu J, Zhang C, Jiang J, Chen G, Chen J, Liu Q, Xu G, Lan Y. Identifying biomarkers related to motor function in chronic stroke: A fNIRS and TMS study. CNS Neurosci Ther 2024; 30:e14889. [PMID: 39073240 DOI: 10.1111/cns.14889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/07/2024] [Accepted: 07/17/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Upper limb motor impairment commonly occurs after stroke, impairing quality of life. Brain network reorganization likely differs between subgroups with differing impairment severity. This study explored differences in functional connectivity (FC) and corticospinal tract (CST) integrity between patients with mild/moderate versus severe hemiplegia poststroke to clarify the neural correlates underlying motor deficits. METHOD Sixty chronic stroke patients with upper limb motor impairment were categorized into mild/moderate and severe groups based on Fugl-Meyer scores. Resting-state FC was assessed using functional near-infrared spectroscopy (fNIRS) to compare connectivity patterns between groups across motor regions. CST integrity was evaluated by inducing motor evoked potentials (MEP) via transcranial magnetic stimulation. RESULTS Compared to the mild/moderate group, the severe group exhibited heightened premotor cortex-primary motor cortex (PMC-M1) connectivity (t = 4.56, p < 0.01). Absence of MEP was also more frequent in the severe group (χ2 = 12.31, p = 0.01). Bayesian models effectively distinguished subgroups and identified the PMC-M1 connection as highly contributory (accuracy = 91.30%, area under the receiver operating characteristic curve [AUC] = 0.86). CONCLUSION Distinct patterns of connectivity and corticospinal integrity exist between stroke subgroups with differing impairments. Strengthened connectivity potentially indicates recruitment of additional motor resources to compensate for damage. These findings elucidate the neural correlates underlying motor deficits poststroke and could guide personalized, network-based therapies targeting predictive biomarkers to improve rehabilitation outcomes.
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Affiliation(s)
- Guiyuan Cai
- Department of Rehabilitation Medicine, School of Medicine, The Second Affiliated Hospital, South China University of Technology, Guangzhou, China
- Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Jiayue Xu
- Department of Rehabilitation Medicine, School of Medicine, The Second Affiliated Hospital, South China University of Technology, Guangzhou, China
- Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Cailing Zhang
- Department of Rehabilitation Medicine, School of Medicine, The Second Affiliated Hospital, South China University of Technology, Guangzhou, China
- Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Junbo Jiang
- Department of Rehabilitation Medicine, School of Medicine, The Second Affiliated Hospital, South China University of Technology, Guangzhou, China
- Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Gengbin Chen
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Jialin Chen
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Quan Liu
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Guangqing Xu
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yue Lan
- Department of Rehabilitation Medicine, School of Medicine, The Second Affiliated Hospital, South China University of Technology, Guangzhou, China
- Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
- Guangzhou Key Laboratory of Aging Frailty and Neurorehabilitation, Guangzhou, China
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Afzal A, Thomas N, Warraich Z, Barbay S, Mocco J. Hematopoietic Endothelial Progenitor cells enhance motor function and cortical motor map integrity following cerebral ischemia. Restor Neurol Neurosci 2024:RNN231378. [PMID: 38820024 DOI: 10.3233/rnn-231378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
Background Hematopoietic stem cells (HSC) are recruited to ischemic areas in the brain and contribute to improved functional outcome in animals. However, little is known regarding the mechanisms of improvement following HSC administration post cerebral ischemia. To better understand how HSC effect post-stroke improvement, we examined the effect of HSC in ameliorating motor impairment and cortical dysfunction following cerebral ischemia. Methods Baseline motor performance of male adult rats was established on validated motor tests. Animals were assigned to one of three experimental cohorts: control, stroke, stroke + HSC. One, three and five weeks following a unilateral stroke all animals were tested on motor skills after which intracortical microstimulation was used to derive maps of forelimb movement representations within the motor cortex ipsilateral to the ischemic injury. Results Stroke + HSC animals significantly outperformed stroke animals on single pellet reaching at weeks 3 and 5 (28±3% and 33±3% versus 11±4% and 17±3%, respectively, p < 0.05 at both time points). Control animals scored 44±1% and 47±1%, respectively. Sunflower seed opening task was significantly improved in the stroke + HSC cohort versus the stroke cohort at week five-post stroke (79±4 and 48±5, respectively, p < 0.05). Furthermore, Stroke + HSC animals had significantly larger forelimb motor maps than animals in the stroke cohort. Overall infarct size did not significantly differ between the two stroked cohorts. Conclusion These data suggest that post stroke treatment of HSC enhances the functional integrity of residual cortical tissue, which in turn supports improved behavioral outcome, despite no observed reduction in infarct size.
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Affiliation(s)
- Aqeela Afzal
- Department of Neurological Surgery, Vanderbilt University, Nashville, TN, USA
| | - Nagheme Thomas
- Department of Physiology and Functional Genomics, University of Florida, Gainesville, FL, USA
| | | | - Scott Barbay
- Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, Kansas, KS, USA
| | - J Mocco
- Department of Neurological Surgery, Mount Sinai Health, New York, NY, USA
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Yu J, Joo IL, Bazzigaluppi P, Koletar MM, Cherin E, Stanisz AG, Graham JWC, Demore C, Stefanovic B. Micro-ultrasound based characterization of cerebrovasculature following focal ischemic stroke and upon short-term rehabilitation. J Cereb Blood Flow Metab 2024; 44:461-476. [PMID: 37974304 PMCID: PMC10981404 DOI: 10.1177/0271678x231215004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/21/2023] [Accepted: 10/27/2023] [Indexed: 11/19/2023]
Abstract
Notwithstanding recanalization treatments in the acute stage of stroke, many survivors suffer long-term impairments. Physical rehabilitation is the only widely available strategy for chronic-stage recovery, but its optimization is hindered by limited understanding of its effects on brain structure and function. Using micro-ultrasound, behavioral testing, and electrophysiology, we investigated the impact of skilled reaching rehabilitation on cerebral hemodynamics, motor function, and neuronal activity in a rat model of focal ischemic stroke. A 50 MHz micro-ultrasound transducer and intracortical electrophysiology were utilized to characterize neurovascular changes three weeks following focal ischemia elicited by endothelin-1 injection into the sensorimotor cortex. Sprague-Dawley rats were rehabilitated through tray reaching, and their fine skilled reaching was assessed via the Montoya staircase. Focal ischemia led to a sustained deficit in forelimb reaching; and increased tortuosity of the penetrating vessels in the perilesional cortex; with no lateralization of spontaneous neuronal activity. Rehabilitation improved skilled reaching; decreased cortical vascularity; was associated with elevated peri- vs. contralesional hypercapnia-induced flow homogenization and increased perilesional spontaneous cortical neuronal activity. Our study demonstrated neurovascular plasticity accompanying rehabilitation-elicited functional recovery in the subacute stage following stroke, and multiple micro-ultrasound-based markers of cerebrovascular structure and function modified in recovery from ischemia and upon rehabilitation.
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Affiliation(s)
- Johnson Yu
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
- Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Illsung L Joo
- Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Paolo Bazzigaluppi
- Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- MetaCell, Cagliari, Italy
| | - Margaret M Koletar
- Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Emmanuel Cherin
- Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Andrew G Stanisz
- Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - James WC Graham
- Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Christine Demore
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
- Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Bojana Stefanovic
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
- Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
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Mu J, Hao P, Duan H, Zhao W, Wang Z, Yang Z, Li X. Non-human primate models of focal cortical ischemia for neuronal replacement therapy. J Cereb Blood Flow Metab 2023; 43:1456-1474. [PMID: 37254891 PMCID: PMC10414004 DOI: 10.1177/0271678x231179544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 03/13/2023] [Accepted: 04/26/2023] [Indexed: 06/01/2023]
Abstract
Despite the high prevalence, stroke remains incurable due to the limited regeneration capacity in the central nervous system. Neuronal replacement strategies are highly diverse biomedical fields that attempt to replace lost neurons by utilizing exogenous stem cell transplants, biomaterials, and direct neuronal reprogramming. Although these approaches have achieved encouraging outcomes mostly in the rodent stroke model, further preclinical validation in non-human primates (NHP) is still needed prior to clinical trials. In this paper, we briefly review the recent progress of promising neuronal replacement therapy in NHP stroke studies. Moreover, we summarize the key characteristics of the NHP as highly valuable translational tools and discuss (1) NHP species and their advantages in terms of genetics, physiology, neuroanatomy, immunology, and behavior; (2) various methods for establishing NHP focal ischemic models to study the regenerative and plastic changes associated with motor functional recovery; and (3) a comprehensive analysis of experimentally and clinically accessible outcomes and a potential adaptive mechanism. Our review specifically aims to facilitate the selection of the appropriate NHP cortical ischemic models and efficient prognostic evaluation methods in preclinical stroke research design of neuronal replacement strategies.
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Affiliation(s)
- Jiao Mu
- Beijing Key Laboratory for Biomaterials and Neural Regeneration, School of Engineering Medicine, Beihang University, Beijing, China
| | - Peng Hao
- Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Hongmei Duan
- Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Wen Zhao
- Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Zijue Wang
- Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Zhaoyang Yang
- Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Xiaoguang Li
- Beijing Key Laboratory for Biomaterials and Neural Regeneration, School of Engineering Medicine, Beihang University, Beijing, China
- Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
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Fujimoto A, Enoki H, Hatano K, Sato K, Okanishi T. Finger movement functions remain in the ipsilesional hemisphere and compensation by the contralesional hemisphere might not be expected after hemispherotomy -pre- and post-hemispherotomy evaluations in 8 cases. Brain Dev 2023:S0387-7604(23)00063-3. [PMID: 37028994 DOI: 10.1016/j.braindev.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND We hypothesized that fine finger motor functions are controlled by the ipsilesional hemisphere, and that gross motor functions are compensated for by the contralesional hemisphere after brain injury in humans. The purpose of this study was to compare finger movements before and after hemispherotomy that defunctionated the ipsilesional hemisphere for patients with hemispherical lesions. METHODS We statistically compared Brunnstrom stage of the fingers, arm (upper extremity), and leg (lower extremity) before and after hemispherotomy. Inclusion criteria for this study were: 1) hemispherotomy for hemispherical epilepsy; 2) a ≥ 6-month history of hemiparesis; 3) post-operative follow-up ≥ 6 months; 4) complete freedom from seizures without aura; and 5) application of our protocol for hemispherotomy. RESULTS Among 36 patients who underwent multi-lobe disconnection surgeries, 8 patients (2 girls, 6 boys) met the study criteria. Mean age at surgery was 6.38 years (range, 2-12 years; median, 6 years; standard deviation, 3.5 years). Paresis of the fingers was significantly exacerbated (p = 0.011) compared to pre-operatively, whereas that of the upper limbs (p = 0.07) and lower limbs (p = 0.103) was not. CONCLUSION Finger movement functions tend to remain in the ipsilesional hemisphere after brain injury, whereas gross motor movement functions such as those of the arms and legs are compensated for by the contralesional hemisphere in humans.
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Affiliation(s)
- Ayataka Fujimoto
- Department of Neurosurgery, Seirei Hamamatsu General Hospital, Shizuoka, Japan; Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka, Japan; School of Rehabilitation Sciences, Seirei Christopher University, Shizuoka, Japan.
| | - Hideo Enoki
- Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | - Keisuke Hatano
- Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | - Keishiro Sato
- Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | - Tohru Okanishi
- Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka, Japan
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Plautz EJ, Barbay S, Frost SB, Stowe AM, Dancause N, Zoubina EV, Eisner-Janowicz I, Guggenmos DJ, Nudo RJ. Spared Premotor Areas Undergo Rapid Nonlinear Changes in Functional Organization Following a Focal Ischemic Infarct in Primary Motor Cortex of Squirrel Monkeys. J Neurosci 2023; 43:2021-2032. [PMID: 36788028 PMCID: PMC10027035 DOI: 10.1523/jneurosci.1452-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 02/16/2023] Open
Abstract
Recovery of motor function after stroke is accompanied by reorganization of movement representations in spared cortical motor regions. It is widely assumed that map reorganization parallels recovery, suggesting a causal relationship. We examined this assumption by measuring changes in motor representations in eight male and six female squirrel monkeys in the first few weeks after injury, a time when motor recovery is most rapid. Maps of movement representations were derived using intracortical microstimulation techniques in primary motor cortex (M1), ventral premotor cortex (PMv), and dorsal premotor cortex (PMd) in 14 adult squirrel monkeys before and after a focal infarct in the M1 distal forelimb area. Maps were derived at baseline and at either 2 (n = 7) or 3 weeks (n = 7) postinfarct. In PMv the forelimb maps remained unchanged at 2 weeks but contracted significantly (-42.4%) at 3 weeks. In PMd the forelimb maps expanded significantly (+110.6%) at 2 weeks but contracted significantly (-57.4%) at 3 weeks. Motor deficits were equivalent at both time points. These results highlight two features of plasticity after M1 lesions. First, significant contraction of distal forelimb motor maps in both PMv and PMd is evident by 3 weeks. Second, an unpredictable nonlinear pattern of reorganization occurs in the distal forelimb representation in PMd, first expanding at 2 weeks, and then contracting at 3 weeks postinjury. Together with previous results demonstrating reliable map expansions in PMv several weeks to months after M1 injury, the subacute time period may represent a critical window for the timing of therapeutic interventions.SIGNIFICANCE STATEMENT The relationship between motor recovery and motor map reorganization after cortical injury has rarely been examined in acute/subacute periods. In nonhuman primates, premotor maps were examined at 2 and 3 weeks after injury to primary motor cortex. Although maps are known to expand late after injury, the present study demonstrates early map expansion at 2 weeks (dorsal premotor cortex) followed by contraction at 3 weeks (dorsal and ventral premotor cortex). This nonlinear map reorganization during a time of gradual behavioral recovery suggests that the relationship between map plasticity and motor recovery is much more complex than previously thought. It also suggests that rehabilitative motor training may have its most potent effects during this early dynamic phase of map reorganization.
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Affiliation(s)
- Erik J Plautz
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Scott Barbay
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Shawn B Frost
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Ann M Stowe
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Numa Dancause
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Elena V Zoubina
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Ines Eisner-Janowicz
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - David J Guggenmos
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Randolph J Nudo
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas 66160
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Zhou Z, Chen X, Li Y, Chen S, Zhang S, Wu Y, Shi X, Ren M, Shan C. Effects of integrated action and sensory observation therapy based on mirror neuron and embodied cognition theory on upper limb sensorimotor function in chronic stroke: a study protocol for a randomised controlled trial. BMJ Open 2023; 13:e069126. [PMID: 36882253 PMCID: PMC10008471 DOI: 10.1136/bmjopen-2022-069126] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION This study protocol aims to explore the effectiveness and neural mechanism of the integration of action observation therapy (AOT) and sensory observation therapy (SOT) for post-stroke patients on upper limb sensorimotor function. METHODS AND ANALYSIS This is a single-centre, single-blind, randomised controlled trial. A total of 69 patients with upper extremity hemiparesis after stroke will be recruited and randomly divided into an AOT group, a combined action observation and somatosensory stimulation therapy (AOT+SST) group, and a combined AOT and SOT (AOT+SOT) group in a 1:1:1 ratio. Each group will receive 30 min of daily treatment, five times weekly for 4 weeks. The primary clinical outcome will be the Fugl-Meyer Assessment for Upper Extremity. Secondary clinical outcomes will include the Box and Blocks Test, modified Barthel Index and sensory assessment. All clinical assessments and resting-state functional MRI and diffusion tensor imaging data will be obtained at pre-intervention (T1), post-intervention (T2) and 8 weeks of follow-up (T3). ETHICS AND DISSEMINATION The trial was approved by the Ethics Committee of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Chinese Traditional Medicine (Grant No. 2020-178). The results will be submitted to a peer-review journal or at a conference. TRIAL REGISTRATION NUMBER ChiCTR2000040568.
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Affiliation(s)
- Zhiqing Zhou
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xixi Chen
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanli Li
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
| | - Songmei Chen
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai No. 3 Rehabilitation Hospital, Shanghai, China
| | - Sicong Zhang
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuwei Wu
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaolong Shi
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Meng Ren
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chunlei Shan
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
- Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
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Morecraft RJ, Stilwell-Morecraft KS, Ge J, Kraskov A, Lemon RN. Lack of somatotopy among corticospinal tract fibers passing through the primate craniovertebral junction and cervical spinal cord: pathoanatomical substrate of central cord syndrome and cruciate paralysis. J Neurosurg 2022; 136:1395-1409. [PMID: 34624846 PMCID: PMC10193491 DOI: 10.3171/2021.4.jns202464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 04/21/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In some cases of incomplete cervical spinal cord injury (iSCI) there is marked paresis and dysfunction of upper-extremity movement but not lower-extremity movement. A continued explanation of such symptoms is a somatotopic organization of corticospinal tract (CST) fibers passing through the decussation at the craniovertebral junction (CVJ) and lateral CST (LCST). In central cord syndrome, it has been suggested that injury to the core of the cervical cord may include selective damage to medially located arm/hand LCST fibers, without compromising laterally located leg fibers. Because such somatotopic organization in the primate CST might contribute to the disproportionate motor deficits after some forms of iSCI, the authors made a systematic investigation of CST organization in the CVJ and LCST using modern neuroanatomical techniques. METHODS High-resolution anterograde tracers were used in 11 rhesus macaque monkeys to define the course of the corticospinal projection (CSP) through the CVJ and LCST from the arm/hand, shoulder, and leg areas of the primary motor cortex (M1). This approach labels CST fibers of all sizes, large and small, arising in these areas. The CSP from the dorsolateral and ventrolateral premotor cortex and supplementary motor area were also studied. A stereological approach was adapted to quantify labeled fiber distribution in 8 cases. RESULTS There was no evidence for somatotopic organization of CST fibers passing through the CVJ or contralateral LCST. Fiber labeling from each cortical representation was widespread throughout the CST at the CVJ and LCST and overlapped extensively with fibers from other representations. This study demonstrated no significant difference between medial versus lateral subsectors of the LCST in terms of number of fibers labeled from the M1 arm/hand area. CONCLUSIONS This investigation firmly rejects the concept of somatotopy among CST fibers passing through the CVJ and LCST, in contrast with the somatotopy in the cortex, corona radiata, and internal capsule. All CST fibers in the CVJ and LCST would thus appear to be equally susceptible to focal or diffuse injury, regardless of their cortical origin. The disproportionate impairment of arm/hand movement after iSCI must therefore be due to other factors, including greater dependence of hand/arm movements on the CST compared with the lower limb. The dispersed and intermingled nature of frontomotor fibers may be important in motor recovery after cervical iSCI.
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Affiliation(s)
- Robert J. Morecraft
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota
| | - Kimberly S. Stilwell-Morecraft
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota
| | - Jizhi Ge
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota
| | - Alexander Kraskov
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; and
| | - Roger N. Lemon
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
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A cortical injury model in a non-human primate to assess execution of reach and grasp actions: implications for recovery after traumatic brain injury. J Neurosci Methods 2021; 361:109283. [PMID: 34237383 PMCID: PMC9969347 DOI: 10.1016/j.jneumeth.2021.109283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/29/2021] [Accepted: 07/04/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Technological advances in developing experimentally controlled models of traumatic brain injury (TBI) are prevalent in rodent models and these models have proven invaluable in characterizing temporal changes in brain and behavior after trauma. To date no long-term studies in non-human primates (NHPs) have been published using an experimentally controlled impact device to follow behavioral performance over time. NEW METHOD We have employed a controlled cortical impact (CCI) device to create a focal contusion to the hand area in primary motor cortex (M1) of three New World monkeys to characterize changes in reach and grasp function assessed for 3 months after the injury. RESULTS The CCI destroyed most of M1 hand representation reducing grey matter by 9.6 mm3, 12.9 mm3, and 15.5 mm3 and underlying corona radiata by 7.4 mm3, 6.9 mm3, and 5.6 mm3 respectively. Impaired motor function was confined to the hand contralateral to the injury. Gross hand-use was only mildly affected during the first few days of observation after injury while activity requiring skilled use of the hand was impaired over three months. COMPARISON WITH EXISTING METHOD(S) This study is unique in establishing a CCI model of TBI in an NHP resulting in persistent impairments in motor function evident in volitional use of the hand. CONCLUSIONS Establishing an NHP model of TBI is essential to extend current rodent models to the complex neural architecture of the primate brain. Moving forward this model can be used to investigate novel therapeutic interventions to improve or restore impaired motor function after trauma.
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Zhang SY, Jeffers MS, Lagace DC, Kirton A, Silasi G. Developmental and Interventional Plasticity of Motor Maps after Perinatal Stroke. J Neurosci 2021; 41:6157-6172. [PMID: 34083257 PMCID: PMC8276736 DOI: 10.1523/jneurosci.3185-20.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/14/2021] [Accepted: 05/20/2021] [Indexed: 02/07/2023] Open
Abstract
Within the perinatal stroke field, there is a need to establish preclinical models where putative biomarkers for motor function can be examined. In a mouse model of perinatal stroke, we evaluated motor map size and movement latency following optogenetic cortical stimulation against three factors of post-stroke biomarker utility: (1) correlation to chronic impairment on a behavioral test battery; (2) amenability to change using a skilled motor training paradigm; and (3) ability to distinguish individuals with potential to respond well to training. Thy1-ChR2-YFP mice received a photothrombotic stroke at postnatal day 7 and were evaluated on a battery of motor tests between days 59 and 70. Following a cranial window implant, mice underwent longitudinal optogenetic motor mapping both before and after 3 weeks of skilled forelimb training. Map size and movement latency of both hemispheres were positively correlated with impaired spontaneous forelimb use, whereas only ipsilesional hemisphere map size was correlated with performance in skilled reaching. Map size and movement latency did not show groupwise changes with training; however, mice with the smallest pretraining map sizes and worst impairments demonstrated the greatest expansion of map size in response to skilled forelimb training. Overall, motor map size showed utility as a potential biomarker for impairment and training-induced modulation in specific individuals. Future assessment of the predictive capacity of post-stroke motor representations for behavioral outcome in animal models opens the possibility of dissecting how plasticity mechanisms contribute to recovery following perinatal stroke.SIGNIFICANCE STATEMENT We investigated the utility of two cortical motor representation measures (motor map size and movement onset latency) as potential biomarkers for post-stroke motor recovery in a mouse model of perinatal stroke. Both motor map size and movement latency were associated with functional recovery after perinatal stroke, with map size showing an additional association between training responsiveness and severity of impairment. Overall, both motor map size and movement onset latency show potential as neurophysiological correlates of recovery. As such, future studies of perinatal stroke rehabilitation and neuromodulation should include these measures to help explain neurophysiological changes that might be occurring in response to treatment.
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Affiliation(s)
- Sarah Y Zhang
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada K1H 8M5
| | - Matthew S Jeffers
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada K1H 8M5
| | - Diane C Lagace
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada K1H 8M5
- Ottawa Hospital Research Institute, Neuroscience Program, Ottawa, Ontario, Canada K1H 8L6
- Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada K1H 8M5
| | - Adam Kirton
- Alberta Children's Hospital, Calgary Pediatric Stroke Program, Calgary, Alberta, Canada K1H 8M5
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada T2N 1N4
- Hotchkiss Brain Institute, Calgary, Alberta, Canada T2N 4N1
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada T2N 4N1
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada T2N 4N1
| | - Gergely Silasi
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada K1H 8M5
- Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada K1H 8M5
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11
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Developmental Remodelling of the Motor Cortex in Hemiparetic Children With Perinatal Stroke. Pediatr Neurol 2020; 112:34-43. [PMID: 32911261 DOI: 10.1016/j.pediatrneurol.2020.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/28/2020] [Accepted: 08/01/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Perinatal stroke often leads to lifelong motor impairment. Two common subtypes differ in timing, location, and mechanism of injury: periventricular venous infarcts (PVI) are fetal white matter lesions while most arterial ischemic strokes (AIS) are cortical injuries acquired near term birth. Both alter motor system development and primary motor cortex (M1) plasticity, often with retained ipsilateral corticospinal fibers from the non-lesioned motor cortex (M1'). METHODS Task-based functional magnetic resonance imaging was used to define patterns of motor cortex activity during paretic and unaffected hand movement. Peak coordinates of M1, M1', and the supplementary motor area in the lesioned and intact hemispheres were compared to age-matched controls. Correlations between displacements and clinical motor function were explored. RESULTS Forty-nine participants included 14 PVI (12.59 ± 3.7 years), 13 AIS (14.91 ± 3.9 years), and 22 controls (13.91 ± 3.4 years). AIS displayed the greatest M1 displacement from controls in the lesioned hemisphere while PVI locations approximated controls. Peak M1' activations were displaced from the canonical hand knob in both PVI and AIS. Extent of M1 and M1' displacement were correlated (r = 0.50, P = 0.025) but were not associated with motor function. Supplementary motor area activity elicited by paretic tapping was displaced in AIS compared to controls (P = 0.003). CONCLUSION Motor network components may be displaced in both hemispheres after perinatal stroke, particularly in AIS and those with ipsilateral control of the affected limb. Modest correlations with clinical function may support that more complex models of developmental plasticity are needed to inform targets for individualized neuromodulatory therapies in children with perinatal stroke.
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12
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Affiliation(s)
- David T Bundy
- From the Department of Rehabilitation Medicine (D.T.B., R.J.N.), University of Kansas Medical Center, Kansas City, KS
| | - Randolph J Nudo
- From the Department of Rehabilitation Medicine (D.T.B., R.J.N.), University of Kansas Medical Center, Kansas City, KS.,Landon Center on Aging (R.J.N.), University of Kansas Medical Center, Kansas City, KS
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13
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What is the functional relevance of reorganization in primary motor cortex after spinal cord injury? Neurobiol Dis 2019; 121:286-295. [DOI: 10.1016/j.nbd.2018.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 09/10/2018] [Indexed: 01/15/2023] Open
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14
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Sampaio-Baptista C, Sanders ZB, Johansen-Berg H. Structural Plasticity in Adulthood with Motor Learning and Stroke Rehabilitation. Annu Rev Neurosci 2018; 41:25-40. [DOI: 10.1146/annurev-neuro-080317-062015] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The development of advanced noninvasive techniques to image the human brain has enabled the demonstration of structural plasticity during adulthood in response to motor learning. Understanding the basic mechanisms of structural plasticity in the context of motor learning is essential to improve motor rehabilitation in stroke patients. Here, we review and discuss the emerging evidence for motor-learning-related structural plasticity and the implications for stroke rehabilitation. In the clinical context, a few studies have started to assess the effects of rehabilitation on structural measures to understand recovery poststroke and additionally to predict intervention outcomes. Structural imaging will likely have a role in the future in providing measures that inform patient stratification for optimal outcomes.
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Affiliation(s)
- Cassandra Sampaio-Baptista
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, United Kingdom;,
| | - Zeena-Britt Sanders
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, United Kingdom;,
| | - Heidi Johansen-Berg
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, United Kingdom;,
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15
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O'Shea DJ, Kalanithi P, Ferenczi EA, Hsueh B, Chandrasekaran C, Goo W, Diester I, Ramakrishnan C, Kaufman MT, Ryu SI, Yeom KW, Deisseroth K, Shenoy KV. Development of an optogenetic toolkit for neural circuit dissection in squirrel monkeys. Sci Rep 2018; 8:6775. [PMID: 29712920 PMCID: PMC5928036 DOI: 10.1038/s41598-018-24362-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 04/03/2018] [Indexed: 01/01/2023] Open
Abstract
Optogenetic tools have opened a rich experimental landscape for understanding neural function and disease. Here, we present the first validation of eight optogenetic constructs driven by recombinant adeno-associated virus (AAV) vectors and a WGA-Cre based dual injection strategy for projection targeting in a widely-used New World primate model, the common squirrel monkey Saimiri sciureus. We observed opsin expression around the local injection site and in axonal projections to downstream regions, as well as transduction to thalamic neurons, resembling expression patterns observed in macaques. Optical stimulation drove strong, reliable excitatory responses in local neural populations for two depolarizing opsins in anesthetized monkeys. Finally, we observed continued, healthy opsin expression for at least one year. These data suggest that optogenetic tools can be readily applied in squirrel monkeys, an important first step in enabling precise, targeted manipulation of neural circuits in these highly trainable, cognitively sophisticated animals. In conjunction with similar approaches in macaques and marmosets, optogenetic manipulation of neural circuits in squirrel monkeys will provide functional, comparative insights into neural circuits which subserve dextrous motor control as well as other adaptive behaviors across the primate lineage. Additionally, development of these tools in squirrel monkeys, a well-established model system for several human neurological diseases, can aid in identifying novel treatment strategies.
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Affiliation(s)
- Daniel J O'Shea
- Neurosciences Program, Stanford University, Stanford, CA, USA.
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA.
| | - Paul Kalanithi
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | | | - Brian Hsueh
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | | | - Werapong Goo
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Ilka Diester
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
- Department of Otophysiologie, Albert Ludwig University of Freiburg, Freiburg im Breisgau, Germany
- BrainLinks-BrainTools, Albert Ludwig University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Matthew T Kaufman
- Neurosciences Program, Stanford University, Stanford, CA, USA
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, USA
| | - Stephen I Ryu
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
- Palo Alto Medical Foundation, Palo Alto, CA, USA
| | - Kristen W Yeom
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Karl Deisseroth
- Department of Bioengineering, Stanford University, Stanford, CA, USA
- Department of Psychiatry and Behavioral Science, Stanford University, Stanford, CA, USA
- Howard Hughes Medical Institute, Stanford University, Stanford, CA, USA
| | - Krishna V Shenoy
- Neurosciences Program, Stanford University, Stanford, CA, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
- Department of Neurobiology, Stanford University, Stanford, CA, USA
- Howard Hughes Medical Institute, Stanford University, Stanford, CA, USA
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16
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Cirstea CM, Lee P, Craciunas SC, Choi IY, Burris JE, Nudo RJ. Pre-therapy Neural State of Bilateral Motor and Premotor Cortices Predicts Therapy Gain After Subcortical Stroke: A Pilot Study. Am J Phys Med Rehabil 2017; 97:23-33. [PMID: 28737516 DOI: 10.1097/phm.0000000000000791] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of the study was to examine whether neural state of spared motor and premotor cortices captured before a therapy predicts therapy-related motor gains in chronic subcortical stroke. DESIGN Ten survivors, presenting chronic moderate upper limb impairment, underwent proton magnetic resonance spectroscopy, magnetic resonance imaging, clinical, and kinematics assessments before a 4-wk impairment-oriented training. Clinical/kinematics assessments were repeated after therapy, and motor gain was defined as positive values of clinical upper limb/elbow motion changes and negative values of trunk motion changes. Candidate predictors were N-acetylaspartate-neuronal marker, glutamate-glutamine-indicator of glutamatergic neurotransmission, and myo-inositol-glial marker, measured bilaterally within the upper limb territory in motor and premotor (premotor cortex, supplementary motor area) cortices. Traditional predictors (age, stroke length, pre-therapy upper limb clinical impairment, infarct volume) were also investigated. RESULTS Poor motor gain was associated with lower glutamate-glutamine levels in ipsilesional primary motor cortex and premotor cortex (r = 0.77, P = 0.01 and r = 0.78, P = 0.008, respectively), lower N-acetylaspartate in ipsilesional premotor cortex (r = 0.69, P = 0.02), higher glutamate-glutamine in contralesional primary motor cortex (r = -0.68, P = 0.03), and lower glutamate-glutamine in contralesional supplementary motor area (r = 0.64, P = 0.04). These predictors outperformed myo-inositol metrics and traditional predictors (P ≈ 0.05-1.0). CONCLUSIONS Glutamatergic state of bilateral motor and premotor cortices and neuronal state of ipsilesional premotor cortex may be important for predicting motor outcome in the context of a restorative therapy.
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Affiliation(s)
- Carmen M Cirstea
- From the Departments of Neurology (CMC, I-YC), Molecular & Integrative Physiology (PL), Physical Medicine & Rehabilitation (RJN); Hoglund Brain Imaging Center (CMC, PL, SCC, I-YC), Landon Center on Aging (RJN), University of Kansas Medical Center, Kansas City, Kansas; and Department of Physical Medicine and Rehabilitation, University of Missouri, Columbia, Missouri (CMC, JEB)
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17
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Dai P, Huang H, Zhang L, He J, Zhao X, Yang F, Zhao N, Yang J, Ge L, Lin Y, Yu H, Wang J. A pilot study on transient ischemic stroke induced with endothelin-1 in the rhesus monkeys. Sci Rep 2017; 7:45097. [PMID: 28358140 PMCID: PMC5372164 DOI: 10.1038/srep45097] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 02/17/2017] [Indexed: 12/25/2022] Open
Abstract
Endothelin-1 (ET-1), a vasoconstrictor, has recently been used to induce focal ischemia in rodents and marmoset monkeys. The rhesus monkey, however, has numerous advantages to the rodent and marmoset that make it a superior and irreplaceable animal model for studying stroke in the brain. In the present study, after mapping the preferred hand representation in two healthy male monkeys with intracortical micro-stimulation, ET-1 was microinjected into the contralateral motor cortex (M1) to its preferred hand. The monkeys had been trained in three manual dexterity tasks before the microinjection and were tested for these tasks following the ET-1 injection. Brain Magnetic Resonance Imaging scans were performed 1, 7, 14 and 28 days post ischemia. It was found that ET-1 impaired the manual dexterity of the monkeys in the vertical slot and rotating Brinkman board tasks 3–8 days after the injection. Brain imaging found that severe edema was present 7 days after the focal ischemia. This data suggest that ET-1 can induce transient ischemic stroke in rhesus monkey and that ET-1 induced focal ischemia in non-human primates is a potential model to study the mechanism of stroke and brain repair after stroke.
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Affiliation(s)
- PeiMin Dai
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Primates Research Center, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China.,Department of Neurosurgery, First People's Hospital of Honghe State, Honghe, China
| | - Hui Huang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Primates Research Center, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China.,Department of Neurosurgery, Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lin Zhang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Primates Research Center, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China.,Department of Neurosurgery, Center People's Hospital of Zhumadian State, Zhumadian, China.,Second Department of Neurosurgery, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jing He
- Yunnan Key Laboratory of Primate Biomedical Research Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China
| | - XuDong Zhao
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - FuHan Yang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Primates Research Center, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Ning Zhao
- Second Department of Neurosurgery, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - JianZhen Yang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Primates Research Center, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - LongJiao Ge
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Primates Research Center, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Yu Lin
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Primates Research Center, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - HuaLin Yu
- Second Department of Neurosurgery, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - JianHong Wang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Primates Research Center, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
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18
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Neural network remodeling underlying motor map reorganization induced by rehabilitative training after ischemic stroke. Neuroscience 2016; 339:338-362. [PMID: 27725217 DOI: 10.1016/j.neuroscience.2016.10.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/29/2016] [Accepted: 10/02/2016] [Indexed: 12/20/2022]
Abstract
Motor map reorganization is believed to be one mechanism underlying rehabilitation-induced functional recovery. Although the ipsilesional secondary motor area has been known to reorganize motor maps and contribute to rehabilitation-induced functional recovery, it is unknown how the secondary motor area is reorganized by rehabilitative training. In the present study, using skilled forelimb reaching tasks, we investigated neural network remodeling in the rat rostral forelimb area (RFA) of the secondary motor area during 4weeks of rehabilitative training. Following photothrombotic stroke in the caudal forelimb area (CFA), rehabilitative training led to task-specific recovery and motor map reorganization in the RFA. A second injury to the RFA resulted in reappearance of motor deficits. Further, when both the CFA and RFA were destroyed simultaneously, rehabilitative training no longer improved task-specific recovery. In neural tracer studies, although rehabilitative training did not alter neural projection to the RFA from other brain areas, rehabilitative training increased neural projection from the RFA to the lower spinal cord, which innervates the muscles in the forelimb. Double retrograde tracer studies revealed that rehabilitative training increased the neurons projecting from the RFA to both the upper cervical cord, which innervates the muscles in the neck, trunk, and part of the proximal forelimb, and the lower cervical cord. These results suggest that neurons projecting to the upper cervical cord provide new connections to the denervated forelimb area of the spinal cord, and these new connections may contribute to rehabilitation-induced task-specific recovery and motor map reorganization in the secondary motor area.
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19
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Moore TL, Pessina MA, Finklestein SP, Killiany RJ, Bowley B, Benowitz L, Rosene DL. Inosine enhances recovery of grasp following cortical injury to the primary motor cortex of the rhesus monkey. Restor Neurol Neurosci 2016; 34:827-48. [PMID: 27497459 PMCID: PMC6503840 DOI: 10.3233/rnn-160661] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Inosine, a naturally occurring purine nucleoside, has been shown to stimulate axonal growth in cell culture and promote corticospinal tract axons to sprout collateral branches after stroke, spinal cord injury and TBI in rodent models. OBJECTIVE To explore the effects of inosine on the recovery of motor function following cortical injury in the rhesus monkey. METHODS After being trained on a test of fine motor function of the hand, monkeys received a lesion limited to the area of the hand representation in primary motor cortex. Beginning 24 hours after this injury and continuing daily thereafter, monkeys received orally administered inosine (500 mg) or placebo. Retesting of motor function began on the 14th day after injury and continued for 12 weeks. RESULTS During the first 14 days after surgery, there was evidence of significant recovery within the inosine-treated group on measures of fine motor function of the hand, measures of hand strength and digit flexion. While there was no effect of treatment on the time to retrieve a reward, the treated monkeys returned to asymptotic levels of grasp performance significantly faster than the untreated monkeys. Additionally, the treated monkeys evidenced a greater degree of recovery in terms of maturity of grasp pattern. CONCLUSION These findings demonstrate that inosine can enhance recovery of function following cortical injury in monkeys.
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Affiliation(s)
- Tara L. Moore
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Monica A. Pessina
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | | | - Ronald J. Killiany
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Bethany Bowley
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Larry Benowitz
- Department of Neurosurgery and F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Douglas L. Rosene
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
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20
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Higo N, Kunori N, Murata Y. Neural Activity during Voluntary Movements in Each Body Representation of the Intracortical Microstimulation-Derived Map in the Macaque Motor Cortex. PLoS One 2016; 11:e0160720. [PMID: 27494282 PMCID: PMC4975470 DOI: 10.1371/journal.pone.0160720] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 07/22/2016] [Indexed: 11/18/2022] Open
Abstract
In order to accurately interpret experimental data using the topographic body map identified by conventional intracortical microstimulation (ICMS), it is important to know how neurons in each division of the map respond during voluntary movements. Here we systematically investigated neuronal responses in each body representation of the ICMS map during a reach-grasp-retrieval task that involves the movements of multiple body parts. The topographic body map in the primary motor cortex (M1) generally corresponds to functional divisions of voluntary movements; neurons at the recording sites in each body representation with movement thresholds of 10 μA or less were differentially activated during the task, and the timing of responses was consistent with the movements of the body part represented. Moreover, neurons in the digit representation responded differently for the different types of grasping. In addition, the present study showed that neural activity depends on the ICMS current threshold required to elicit body movements and the location of the recording on the cortical surface. In the ventral premotor cortex (PMv), no correlation was found between the response properties of neurons and the body representation in the ICMS map. Neural responses specific to forelimb movements were often observed in the rostral part of PMv, including the lateral bank of the lower arcuate limb, in which ICMS up to 100 μA evoked no detectable movement. These results indicate that the physiological significance of the ICMS-derived maps is different between, and even within, areas M1 and PMv.
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Affiliation(s)
- Noriyuki Higo
- Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, 305–8568, Japan
- Precursory Research for Embryonic Science and Technology (PRESTO), JST, Kawaguchi, Saitama, 332–0012, Japan
- * E-mail:
| | - Nobuo Kunori
- Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, 305–8568, Japan
- Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Ibaraki, 305–8574, Japan
| | - Yumi Murata
- Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, 305–8568, Japan
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21
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Kubis N. Non-Invasive Brain Stimulation to Enhance Post-Stroke Recovery. Front Neural Circuits 2016; 10:56. [PMID: 27512367 PMCID: PMC4961863 DOI: 10.3389/fncir.2016.00056] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 07/14/2016] [Indexed: 12/22/2022] Open
Abstract
Brain plasticity after stroke remains poorly understood. Patients may improve spontaneously within the first 3 months and then more slowly in the coming year. The first day, decreased edema and reperfusion of the ischemic penumbra may possibly account for these phenomena, but the improvement during the next weeks suggests plasticity phenomena and cortical reorganization of the brain ischemic areas and of more remote areas. Indeed, the injured ischemic motor cortex has a reduced cortical excitability at the acute phase and a suspension of the topographic representation of affected muscles, whereas the contralateral motor cortex has an increased excitability and an enlarged somatomotor representation; furthermore, contralateral cortex exerts a transcallosal interhemispheric inhibition on the ischemic cortex. This results from the imbalance of the physiological reciprocal interhemispheric inhibition of each hemisphere on the other, contributing to worsening of neurological deficit. Cortical excitability is measurable through transcranial magnetic stimulation (TMS) and prognosis has been established according to the presence of motor evoked potentials (MEP) at the acute phase of stroke, which is predictive of better recovery. Conversely, the lack of response to early stimulation is associated with a poor functional outcome. Non-invasive stimulation techniques such as repetitive TMS (rTMS) or transcranial direct current stimulation (tDCS) have the potential to modulate brain cortical excitability with long lasting effects. In the setting of cerebrovascular disease, around 1000 stroke subjects have been included in placebo-controlled trials so far, most often with an objective of promoting motor recovery of the upper limb. High frequency repetitive stimulation (>3 Hz) rTMS, aiming to increase excitability of the ischemic cortex, or low frequency repetitive stimulation (≤1 Hz), aiming to reduce excitability of the contralateral homonymous cortex, or combined therapies, have shown various effects on the functional disability score and neurological scales of treated patients and on the duration of the treatment. We review here the patients’ characteristics and parameters of stimulation that could predict a good response, as well as safety issues. At last, we review what we have learnt from experimental studies and discuss potential directions to conduct future studies.
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Affiliation(s)
- Nathalie Kubis
- Service de Physiologie Clinique, AP-HP, Hôpital LariboisièreParis, France; Université Paris Diderot, Sorbonne Paris Cité, CART, INSERM U965Paris, France
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Protein Synthesis Inhibition in the Peri-Infarct Cortex Slows Motor Recovery in Rats. PLoS One 2016; 11:e0157859. [PMID: 27314672 PMCID: PMC4912164 DOI: 10.1371/journal.pone.0157859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 06/06/2016] [Indexed: 12/02/2022] Open
Abstract
Neuroplasticity and reorganization of brain motor networks are thought to enable recovery of motor function after ischemic stroke. Especially in the cortex surrounding the ischemic scar (i.e., peri-infarct cortex), evidence for lasting reorganization has been found at the level of neurons and networks. This reorganization depends on expression of specific genes and subsequent protein synthesis. To test the functional relevance of the peri-infarct cortex for recovery we assessed the effect of protein synthesis inhibition within this region after experimental stroke. Long-Evans rats were trained to perform a skilled-reaching task (SRT) until they reached plateau performance. A photothrombotic stroke was induced in the forelimb representation of the primary motor cortex (M1) contralateral to the trained paw. The SRT was re-trained after stroke while the protein synthesis inhibitor anisomycin (ANI) or saline were injected into the peri-infarct cortex through implanted cannulas. ANI injections reduced protein synthesis within the peri-infarct cortex by 69% and significantly impaired recovery of reaching performance through re-training. Improvement of motor performance within a single training session remained intact, while improvement between training sessions was impaired. ANI injections did not affect infarct size. Thus, protein synthesis inhibition within the peri-infarct cortex impairs recovery of motor deficits after ischemic stroke by interfering with consolidation of motor memory between training sessions but not short-term improvements within one session.
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Causal Link between the Cortico-Rubral Pathway and Functional Recovery through Forced Impaired Limb Use in Rats with Stroke. J Neurosci 2016; 36:455-67. [PMID: 26758837 DOI: 10.1523/jneurosci.2399-15.2016] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
UNLABELLED Intensive rehabilitation is believed to induce use-dependent plasticity in the injured nervous system; however, its causal relationship to functional recovery is unclear. Here, we performed systematic analysis of the effects of forced use of an impaired forelimb on the recovery of rats after lesioning the internal capsule with intracerebral hemorrhage (ICH). Forced limb use (FLU) group rats exhibited better recovery of skilled forelimb functions and their cortical motor area with forelimb representation was restored and enlarged on the ipsilesional side. In addition, abundant axonal sprouting from the reemerged forelimb area was found in the ipsilateral red nucleus after FLU. To test the causal relationship between the plasticity in the cortico-rubral pathway and recovery, loss-of-function experiments were conducted using a double-viral vector technique, which induces selective blockade of the target pathway. Blockade of the cortico-rubral tract resulted in deficits of the recovered forelimb function in FLU group rats. These findings suggest that the cortico-rubral pathway is a substrate for recovery induced by intensive rehabilitation after ICH. SIGNIFICANCE STATEMENT The research aimed at determining the causal linkage between reorganization of the motor pathway induced by intensive rehabilitative training and recovery after stroke. We clarified the expansion of the forelimb representation area of the ipsilesional motor cortex by forced impaired forelimb use (FLU) after lesioning the internal capsule with intracerebral hemorrhaging (ICH) in rats. Anterograde tracing showed robust axonal sprouting from the forelimb area to the red nucleus in response to FLU. Selective blockade of the cortico-rubral pathway by the novel double-viral vector technique clearly revealed that the increased cortico-rubral axonal projections had causal linkage to the recovery of reaching movements induced by FLU. Our data demonstrate that the cortico-rubral pathway is responsible for the effect of intensive limb use.
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Dancause N. Plasticity in the motor network following primary motor cortex lesion. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 782:61-86. [PMID: 23296481 DOI: 10.1007/978-1-4614-5465-6_4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- Numa Dancause
- Groupe de Recherche sur le Système Nerveux Central (GRSNC), Département de Physiologie, Pavillon Paul-G-Desmarais, Université de Montréal, 2960, Chemin de la Tour, bureau 4138, H3T 1J4, Montréal, Québec, Canada,
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Darling WG, Pizzimenti MA, Rotella DL, Hynes SM, Ge J, Stilwell-Morecraft K, Morecraft RJ. Sensorimotor cortex injury effects on recovery of contralesional dexterous movements in Macaca mulatta. Exp Neurol 2016; 281:37-52. [PMID: 27091225 DOI: 10.1016/j.expneurol.2016.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 04/02/2016] [Accepted: 04/04/2016] [Indexed: 12/19/2022]
Abstract
The effects of primary somatosensory cortex (S1) injury on recovery of contralateral upper limb reaching and grasping were studied by comparing the consequences of isolated lesions to the arm/hand region of primary motor cortex (M1) and lateral premotor cortex (LPMC) to lesions of these same areas plus anterior parietal cortex (S1 and rostral area PE). We used multiple linear regression to assess the effects of gray and white matter lesion volumes on deficits in reaching and fine motor performance during the first month after the lesion, and during recovery of function over 3, 6 and 12months post-injury in 13 monkeys. Subjects with frontoparietal lesions exhibited larger deficits and poorer recovery as predicted, including one subject with extensive peri-Rolandic injury developing learned nonuse after showing signs of recovery. Regression analyses showed that total white matter lesion volume was strongly associated with initial post-lesion deficits in motor performance and with recovery of skill in reaching and manipulation. Multiple regression analyses using percent damage to caudal M1 (M1c), rostral S1 (S1r), LPMC and area PE as predictor variables showed that S1r lesion volumes were closely related to delayed post-lesion recovery of upper limb function, as well as lower skill level of recovery. In contrast, M1c lesion volume was related primarily to initial post-lesion deficits in hand motor performance. Overall, these findings demonstrate that frontoparietal injury impairs hand motor function more so than frontal motor injury alone, and results in slower and poorer recovery than lesions limited to frontal motor cortex.
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Affiliation(s)
- Warren G Darling
- Department of Health and Human Physiology, Motor Control Laboratories, The University of Iowa, Iowa City, IA 52242, United States.
| | - Marc A Pizzimenti
- Department of Anatomy and Cell Biology, Carver College of Medicine, The University of Iowa, Iowa City, IA 52242, United States
| | - Diane L Rotella
- Department of Health and Human Physiology, Motor Control Laboratories, The University of Iowa, Iowa City, IA 52242, United States
| | - Stephanie M Hynes
- Department of Health and Human Physiology, Motor Control Laboratories, The University of Iowa, Iowa City, IA 52242, United States
| | - Jizhi Ge
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, SD 57069, United States
| | - Kimberly Stilwell-Morecraft
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, SD 57069, United States
| | - Robert J Morecraft
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, SD 57069, United States
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Models to Tailor Brain Stimulation Therapies in Stroke. Neural Plast 2016; 2016:4071620. [PMID: 27006833 PMCID: PMC4781989 DOI: 10.1155/2016/4071620] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 12/30/2015] [Accepted: 01/04/2016] [Indexed: 11/18/2022] Open
Abstract
A great challenge facing stroke rehabilitation is the lack of information on how to derive targeted therapies. As such, techniques once considered promising, such as brain stimulation, have demonstrated mixed efficacy across heterogeneous samples in clinical studies. Here, we explain reasons, citing its one-type-suits-all approach as the primary cause of variable efficacy. We present evidence supporting the role of alternate substrates, which can be targeted instead in patients with greater damage and deficit. Building on this groundwork, this review will also discuss different frameworks on how to tailor brain stimulation therapies. To the best of our knowledge, our report is the first instance that enumerates and compares across theoretical models from upper limb recovery and conditions like aphasia and depression. Here, we explain how different models capture heterogeneity across patients and how they can be used to predict which patients would best respond to what treatments to develop targeted, individualized brain stimulation therapies. Our intent is to weigh pros and cons of testing each type of model so brain stimulation is successfully tailored to maximize upper limb recovery in stroke.
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Friel KM, Kuo HC, Fuller J, Ferre CL, Brandão M, Carmel JB, Bleyenheuft Y, Gowatsky JL, Stanford AD, Rowny SB, Luber B, Bassi B, Murphy DLK, Lisanby SH, Gordon AM. Skilled Bimanual Training Drives Motor Cortex Plasticity in Children With Unilateral Cerebral Palsy. Neurorehabil Neural Repair 2016; 30:834-44. [PMID: 26867559 DOI: 10.1177/1545968315625838] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Intensive bimanual therapy can improve hand function in children with unilateral spastic cerebral palsy (USCP). We compared the effects of structured bimanual skill training versus unstructured bimanual practice on motor outcomes and motor map plasticity in children with USCP. Objective We hypothesized that structured skill training would produce greater motor map plasticity than unstructured practice. Methods Twenty children with USCP (average age 9.5; 12 males) received therapy in a day camp setting, 6 h/day, 5 days/week, for 3 weeks. In structured skill training (n = 10), children performed progressively more difficult movements and practiced functional goals. In unstructured practice (n = 10), children engaged in bimanual activities but did not practice skillful movements or functional goals. We used the Assisting Hand Assessment (AHA), Jebsen-Taylor Test of Hand Function (JTTHF), and Canadian Occupational Performance Measure (COPM) to measure hand function. We used single-pulse transcranial magnetic stimulation to map the representation of first dorsal interosseous and flexor carpi radialis muscles bilaterally. Results Both groups showed significant improvements in bimanual hand use (AHA; P < .05) and hand dexterity (JTTHF; P < .001). However, only the structured skill group showed increases in the size of the affected hand motor map and amplitudes of motor evoked potentials (P < .01). Most children who showed the most functional improvements (COPM) had the largest changes in map size. Conclusions These findings uncover a dichotomy of plasticity: the unstructured practice group improved hand function but did not show changes in motor maps. Skill training is important for driving motor cortex plasticity in children with USCP.
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Affiliation(s)
- Kathleen M Friel
- Burke-Cornell Medical Research Institute, White Plains, NY, USA Teachers College, Columbia University, New York, NY, USA Weill Cornell Medical College, New York, NY, USA
| | | | - Jason Fuller
- Burke-Cornell Medical Research Institute, White Plains, NY, USA New York University, New York, NY, USA
| | | | - Marina Brandão
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jason B Carmel
- Burke-Cornell Medical Research Institute, White Plains, NY, USA Weill Cornell Medical College, New York, NY, USA
| | | | | | | | | | | | - Bruce Bassi
- Columbia University Medical Center, New York, NY, USA
| | | | - Sarah H Lisanby
- Division of Translational Research, National Institutes of Health, Bethesda, MD, USA
| | - Andrew M Gordon
- Teachers College, Columbia University, New York, NY, USA Columbia University Medical Center, New York, NY, USA
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Dea M, Hamadjida A, Elgbeili G, Quessy S, Dancause N. Different Patterns of Cortical Inputs to Subregions of the Primary Motor Cortex Hand Representation in Cebus apella. Cereb Cortex 2016; 26:1747-61. [PMID: 26966266 PMCID: PMC4785954 DOI: 10.1093/cercor/bhv324] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The primary motor cortex (M1) plays an essential role in the control of hand movements in primates and is part of a complex cortical sensorimotor network involving multiple premotor and parietal areas. In a previous study in squirrel monkeys, we found that the ventral premotor cortex (PMv) projected mainly to 3 regions within the M1 forearm representation [rostro-medial (RM), rostro-lateral (RL), and caudo-lateral (CL)] with very few caudo-medial (CM) projections. These results suggest that projections from premotor areas to M1 are not uniform, but rather segregated into subregions. The goal of the present work was to study how inputs from diverse areas of the ipsilateral cortical network are organized within the M1 hand representation. In Cebus apella, different retrograde neuroanatomical tracers were injected in 4 subregions of the hand area of M1 (RM, RL, CM, and CL). We found a different pattern of input to each subregion of M1. RM receives inputs predominantly from dorsal premotor cortex, RL from PMv, CM from area 5, and CL from area 2. These results support that the M1 hand representation is composed of several subregions, each part of a unique cortical network.
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Affiliation(s)
- Melvin Dea
- Département de Neurosciences, Université de Montréal, Montréal, Québec, Canada
| | - Adjia Hamadjida
- Département de Neurosciences, Université de Montréal, Montréal, Québec, Canada Groupe de recherche sur le système nerveux central (GRSNC), Université de Montréal, Montréal, Québec, Canada
| | - Guillaume Elgbeili
- Psychosocial Research Division, Douglas Institute Research Centre, Verdun, QC, Canada
| | - Stephan Quessy
- Département de Neurosciences, Université de Montréal, Montréal, Québec, Canada
| | - Numa Dancause
- Département de Neurosciences, Université de Montréal, Montréal, Québec, Canada Groupe de recherche sur le système nerveux central (GRSNC), Université de Montréal, Montréal, Québec, Canada
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Buetefisch CM. Role of the Contralesional Hemisphere in Post-Stroke Recovery of Upper Extremity Motor Function. Front Neurol 2015; 6:214. [PMID: 26528236 PMCID: PMC4607877 DOI: 10.3389/fneur.2015.00214] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 09/22/2015] [Indexed: 12/14/2022] Open
Abstract
Identification of optimal treatment strategies to improve recovery is limited by the incomplete understanding of the neurobiological principles of recovery. Motor cortex (M1) reorganization of the lesioned hemisphere (ipsilesional M1) plays a major role in post-stroke motor recovery and is a primary target for rehabilitation therapy. Reorganization of M1 in the hemisphere contralateral to the stroke (contralesional M1) may, however, serve as an additional source of cortical reorganization and related recovery. The extent and outcome of such reorganization depends on many factors, including lesion size and time since stroke. In the chronic phase post-stroke, contralesional M1 seems to interfere with motor function of the paretic limb in a subset of patients, possibly through abnormally increased inhibition of lesioned M1 by the contralesional M1. In such patients, decreasing contralesional M1 excitability by cortical stimulation results in improved performance of the paretic limb. However, emerging evidence suggests a potentially supportive role of contralesional M1. After infarction of M1 or its corticospinal projections, there is abnormally increased excitatory neural activity and activation in contralesional M1 that correlates with favorable motor recovery. Decreasing contralesional M1 excitability in these patients may result in deterioration of paretic limb performance. In animal stroke models, reorganizational changes in contralesional M1 depend on the lesion size and rehabilitation treatment and include long-term changes in neurotransmitter systems, dendritic growth, and synapse formation. While there is, therefore, some evidence that activity in contralesional M1 will impact the extent of motor function of the paretic limb in the subacute and chronic phase post-stroke and may serve as a new target for rehabilitation treatment strategies, the precise factors that specifically influence its role in the recovery process remain to be defined.
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Affiliation(s)
- Cathrin M Buetefisch
- Emory University , Atlanta, GA , USA ; Georgia Institute of Technology , Atlanta, GA , USA
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Evidence for a role of the reticulospinal system in recovery of skilled reaching after cortical stroke: initial results from a model of ischemic cortical injury. Exp Brain Res 2015; 233:3231-51. [PMID: 26231990 DOI: 10.1007/s00221-015-4390-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 07/13/2015] [Indexed: 12/25/2022]
Abstract
The purposes of this pilot study were to create a model of focal cortical ischemia in Macaca fascicularis and to explore contributions of the reticulospinal system in recovery of reaching. Endothelin-1 was used to create a focal lesion in the shoulder/elbow representation of left primary motor cortex (M1) of two adult female macaques. Repetitive microstimulation was used to map upper limb motor outputs from right and left cortical motor areas and from the pontomedullary reticular formation (PMRF). In subject 1 with a small lesion and spontaneous recovery, reaching was mildly impaired. Changes were evident in the shoulder/elbow representations of both the lesioned and contralesional M1, and there appeared to be fewer than expected upper limb responses from the left (ipsilesional) PMRF. In subject 2 with a substantial lesion, reaching was severely impaired immediately after the lesion. After 12 weeks of intensive rehabilitative training, reach performance recovered to near-baseline levels, but movement times remained about 50% slower. Surprisingly, the shoulder/elbow representation in the lesioned M1 remained completely absent after recovery, and there was a little change in the contralesional M1. There was a definite difference in motor output patterns for left versus right PMRF for this subject, with an increase in right arm responses from right PMRF and a paucity of left arm responses from left PMRF. The results are consistent with increased reliance on PMRF motor outputs for recovery of voluntary upper limb motor control after significant cortical ischemic injury.
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Barbay S, Plautz EJ, Zoubina E, Frost SB, Cramer SC, Nudo RJ. Effects of Postinfarct Myelin-Associated Glycoprotein Antibody Treatment on Motor Recovery and Motor Map Plasticity in Squirrel Monkeys. Stroke 2015; 46:1620-5. [DOI: 10.1161/strokeaha.114.008088] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 03/16/2015] [Indexed: 01/02/2023]
Abstract
Background and Purpose—
New insights into the brain’s ability to reorganize after injury are beginning to suggest novel restorative therapy targets. Potential therapies include pharmacological agents designed to promote axonal growth. The purpose of this study was to test the efficacy of one such drug, GSK249320, a monoclonal antibody that blocks the axon outgrowth inhibition molecule, myelin-associated glycoprotein, to facilitate recovery of motor skills in a nonhuman primate model of ischemic cortical damage.
Methods—
Using a between-groups repeated-measures design, squirrel monkeys were randomized to 1 of 2 groups: an experimental group received intravenous GSK249320 beginning 24 hours after an ischemic infarct in motor cortex with repeated dosages given at 1-week intervals for 6 weeks and a control group received only the vehicle at matched time periods. The primary end point was a motor performance index based on a distal forelimb reach-and-retrieval task. Neurophysiological mapping techniques were used to determine changes in spared motor representations.
Results—
All monkeys recovered to baseline motor performance levels by postinfarct day 16. Functional recovery in the experimental group was significantly facilitated on the primary end point, albeit using slower movements. At 7 weeks post infarct, motor maps in the spared ventral premotor cortex in the experimental group decreased in area compared with the control group.
Conclusions—
GSK249320, initiated 24 hours after a focal cortical ischemic infarct, facilitated functional recovery. Together with the neurophysiological data, these results suggest that GSK249320 has a substantial biological effect on spared cortical tissue. However, its mechanisms of action may be widespread and not strictly limited to peri-infarct cortex and nearby premotor areas.
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Affiliation(s)
- Scott Barbay
- From the Department of Molecular and Integrative Physiology, Landon Center on Aging, University of Kansas Medical Center (S.B., E.J.P., E.Z., S.B.F., R.J.N.); and Department of Neurology and Department of Anatomy and Neurobiology, University of California, Irvine (S.C.C.)
| | - Erik J. Plautz
- From the Department of Molecular and Integrative Physiology, Landon Center on Aging, University of Kansas Medical Center (S.B., E.J.P., E.Z., S.B.F., R.J.N.); and Department of Neurology and Department of Anatomy and Neurobiology, University of California, Irvine (S.C.C.)
| | - Elena Zoubina
- From the Department of Molecular and Integrative Physiology, Landon Center on Aging, University of Kansas Medical Center (S.B., E.J.P., E.Z., S.B.F., R.J.N.); and Department of Neurology and Department of Anatomy and Neurobiology, University of California, Irvine (S.C.C.)
| | - Shawn B. Frost
- From the Department of Molecular and Integrative Physiology, Landon Center on Aging, University of Kansas Medical Center (S.B., E.J.P., E.Z., S.B.F., R.J.N.); and Department of Neurology and Department of Anatomy and Neurobiology, University of California, Irvine (S.C.C.)
| | - Steven C. Cramer
- From the Department of Molecular and Integrative Physiology, Landon Center on Aging, University of Kansas Medical Center (S.B., E.J.P., E.Z., S.B.F., R.J.N.); and Department of Neurology and Department of Anatomy and Neurobiology, University of California, Irvine (S.C.C.)
| | - Randolph J. Nudo
- From the Department of Molecular and Integrative Physiology, Landon Center on Aging, University of Kansas Medical Center (S.B., E.J.P., E.Z., S.B.F., R.J.N.); and Department of Neurology and Department of Anatomy and Neurobiology, University of California, Irvine (S.C.C.)
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Touvykine B, Mansoori BK, Jean-Charles L, Deffeyes J, Quessy S, Dancause N. The Effect of Lesion Size on the Organization of the Ipsilesional and Contralesional Motor Cortex. Neurorehabil Neural Repair 2015; 30:280-92. [PMID: 25967757 PMCID: PMC4766967 DOI: 10.1177/1545968315585356] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Recovery of hand function following lesions in the primary motor cortex (M1) is associated with a reorganization of premotor areas in the ipsilesional hemisphere, and this reorganization depends on the size of the lesion. It is not clear how lesion size affects motor representations in the contralesional hemisphere and how the effects in the 2 hemispheres compare. Our goal was to study how lesion size affects motor representations in the ipsilesional and contralesional hemispheres. In rats, we induced lesions of different sizes in the caudal forelimb area (CFA), the equivalent of M1. The effective lesion volume in each animal was quantified histologically. Behavioral recovery was evaluated with the Montoya Staircase task for 28 days after the lesion. Then, the organization of the CFA and the rostral forelimb area (RFA)—the putative premotor area in rats—in the 2 cerebral hemispheres was studied with intracortical microstimulation mapping techniques. The distal forelimb representation in the RFA of both the ipsilesional and contralesional hemispheres was positively correlated with the size of the lesion. In contrast, lesion size had no effect on the contralesional CFA, and there was no relationship between movement representations in the 2 hemispheres. Finally, only the contralesional RFA was negatively correlated with chronic motor deficits of the paretic forelimb. Our data show that lesion size has comparable effects on motor representations in premotor areas of both hemispheres and suggest that the contralesional premotor cortex may play a greater role in the recovery of the paretic forelimb following large lesions.
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Affiliation(s)
- Boris Touvykine
- Département de Neurosciences, Université de Montréal, Montréal, QC, Canada
| | - Babak K Mansoori
- Département de Biologie moléculaire, Biochimie médicale et pathologie, Université Laval, Québec, QC, Canada
| | - Loyda Jean-Charles
- Département de Neurosciences, Université de Montréal, Montréal, QC, Canada
| | - Joan Deffeyes
- Département de Neurosciences, Université de Montréal, Montréal, QC, Canada
| | - Stephan Quessy
- Département de Neurosciences, Université de Montréal, Montréal, QC, Canada
| | - Numa Dancause
- Département de Neurosciences, Université de Montréal, Montréal, QC, Canada Groupe de Recherche sur le Système Nerveux Central (GRSNC), Université de Montréal, Montréal, QC, Canada
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Deffeyes JE, Touvykine B, Quessy S, Dancause N. Interactions between rostral and caudal cortical motor areas in the rat. J Neurophysiol 2015; 113:3893-904. [PMID: 25855697 PMCID: PMC4480625 DOI: 10.1152/jn.00760.2014] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 04/07/2015] [Indexed: 11/22/2022] Open
Abstract
In rats, forelimb movements can be evoked from two distinct cortical regions, the rostral (RFA) and the caudal (CFA) forelimb areas. RFA and CFA have numerous reciprocal connections, and their projections reach several common targets, which allows them to interact at multiple levels of the motor axis. Lesions affecting these areas result in profound and persistent deficits, supporting their essential role for the production of arm and hand movements. Whereas rats are widely used to study motor control and recovery following lesions, little is known as to how cortical motor areas in this model interact to generate movements. To study interactions between RFA and CFA, we used paired-pulse protocols with intracortical microstimulation techniques (ICMS). A conditioning stimulus (C) in RFA was applied simultaneously, or before a test stimulus (T) in CFA. The impact of RFA conditioning on CFA outputs was quantified by recording electromyographic signals (EMG) signals from the contralateral arm muscles. We found that stimulation of RFA substantially modulates the intensity of CFA outputs while only mildly affecting the latency. In general, the effect of RFA conditioning changed from predominantly facilitatory to inhibitory with increasing delays between the C and the T stimulus. However, inspection of individual cortical sites revealed that RFA has a wide range of influence on CFA outputs with each interstimulation delay we used. Our results show that RFA has powerful and complex modulatory effects on CFA outputs that can allow it to play a major role in the cortical control of forelimb movements.
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Affiliation(s)
- J E Deffeyes
- Département de Neurosciences, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada; and
| | - B Touvykine
- Département de Neurosciences, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada; and
| | - S Quessy
- Département de Neurosciences, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada; and
| | - N Dancause
- Département de Neurosciences, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada; and Groupe de recherche sur le système nerveux central, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada
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Moberget T, Andersson S, Lundar T, Due-Tønnessen B, Heldal A, Endestad T, Westlye L. Long-term supratentorial brain structure and cognitive function following cerebellar tumour resections in childhood. Neuropsychologia 2015; 69:218-31. [DOI: 10.1016/j.neuropsychologia.2015.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 01/21/2015] [Accepted: 02/05/2015] [Indexed: 01/17/2023]
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Tennant KA, Kerr AL, Adkins DL, Donlan N, Thomas N, Kleim JA, Jones TA. Age-dependent reorganization of peri-infarct "premotor" cortex with task-specific rehabilitative training in mice. Neurorehabil Neural Repair 2015; 29:193-202. [PMID: 25009222 PMCID: PMC4277492 DOI: 10.1177/1545968314541329] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The incidence of stroke in adulthood increases with advancing age, but there is little understanding of how poststroke treatment should be tailored by age. OBJECTIVE The goal of this study was to determine if age and task specificity of rehabilitative training affect behavioral improvement and motor cortical organization after stroke. METHODS Young and aged mice were trained to proficiency on the Pasta Matrix Reaching Task prior to lesion induction in primary motor cortex with endothelin-1. After a short recovery period, mice received 9 weeks of rehabilitative training on either the previously learned task (Pasta Matrix Reaching), a different reaching task (Tray Reaching), or no training. To determine the extent of relearning, mice were tested once weekly on the Pasta Matrix Reaching Task. Mice then underwent intracortical microstimulation mapping to resolve the remaining forelimb movement representations in perilesion motor cortex. RESULTS Although aged mice had significantly larger lesions compared with young mice, Pasta Matrix Reaching served as effective rehabilitative training for both age-groups. Young animals also showed improvement after Tray Reaching. Behavioral improvement in young mice was associated with an expansion of the rostral forelimb area ("premotor" cortex), but we failed to see reorganization in the aged brain, despite similar behavioral improvements. CONCLUSIONS Our results indicate that reorganization of motor cortex may be limited by either aging or greater tissue damage, but the capacity to improve motor function via task-specific rehabilitative training continues to be well maintained in aged animals.
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Affiliation(s)
- Kelly A Tennant
- University of Texas at Austin, Austin, TX, USA University of Victoria, Victoria, British Columbia, Canada
| | | | | | | | - Nagheme Thomas
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Jeffrey A Kleim
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, USA
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Morecraft RJ, Ge J, Stilwell-Morecraft KS, McNeal DW, Hynes SM, Pizzimenti MA, Rotella DL, Darling WG. Vulnerability of the medial frontal corticospinal projection accompanies combined lateral frontal and parietal cortex injury in rhesus monkey. J Comp Neurol 2014; 523:669-97. [PMID: 25349147 DOI: 10.1002/cne.23703] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 11/09/2022]
Abstract
Concurrent damage to the lateral frontal and parietal cortex is common following middle cerebral artery infarction, leading to upper extremity paresis, paresthesia, and sensory loss. Motor recovery is often poor, and the mechanisms that support or impede this process are unclear. Since the medial wall of the cerebral hemisphere is commonly spared following stroke, we investigated the spontaneous long-term (6 and 12 month) effects of lateral frontoparietal injury (F2P2 lesion) on the terminal distribution of the corticospinal projection (CSP) from intact, ipsilesional supplementary motor cortex (M2) at spinal levels C5 to T1. Isolated injury to the frontoparietal arm/hand region resulted in a significant loss of contralateral corticospinal boutons from M2 compared with controls. Specifically, reductions occurred in the medial and lateral parts of lamina VII and the dorsal quadrants of lamina IX. There were no statistical differences in the ipsilateral CSP. Contrary to isolated lateral frontal motor injury (F2 lesion), which results in substantial increases in contralateral M2 labeling in laminae VII and IX (McNeal et al. [2010] J. Comp. Neurol. 518:586-621), the added effect of adjacent parietal cortex injury to the frontal motor lesion (F2P2 lesion) not only impedes a favorable compensatory neuroplastic response but results in a substantial loss of M2 CSP terminals. This dramatic reversal of the CSP response suggests a critical trophic role for cortical somatosensory influence on spared ipsilesional frontal corticospinal projections, and that restoration of a favorable compensatory response will require therapeutic intervention.
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Affiliation(s)
- R J Morecraft
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota, 57069
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Optic flow instructs retinotopic map formation through a spatial to temporal to spatial transformation of visual information. Proc Natl Acad Sci U S A 2014; 111:E5105-13. [PMID: 25385606 DOI: 10.1073/pnas.1416953111] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Retinotopic maps are plastic in response to changes in sensory input; however, the experience-dependent instructive cues that organize retinotopy are unclear. In animals with forward-directed locomotion, the predominant anterior to posterior optic flow activates retinal ganglion cells in a stereotyped temporal to nasal sequence. Here we imaged retinotectal axon arbor location and structural plasticity to assess map refinement in vivo while exposing Xenopus tadpoles to visual stimuli. We show that the temporal sequence of retinal activity driven by natural optic flow organizes retinotopy by regulating axon arbor branch dynamics, whereas the opposite sequence of retinal activity prevents map refinement. Our study demonstrates that a spatial to temporal to spatial transformation of visual information controls experience-dependent topographic map plasticity. This organizational principle is likely to apply to other sensory modalities and projections in the brain.
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Di Pino G, Pellegrino G, Assenza G, Capone F, Ferreri F, Formica D, Ranieri F, Tombini M, Ziemann U, Rothwell JC, Di Lazzaro V. Modulation of brain plasticity in stroke: a novel model for neurorehabilitation. Nat Rev Neurol 2014; 10:597-608. [DOI: 10.1038/nrneurol.2014.162] [Citation(s) in RCA: 480] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Nishibe M, Urban ETR, Barbay S, Nudo RJ. Rehabilitative training promotes rapid motor recovery but delayed motor map reorganization in a rat cortical ischemic infarct model. Neurorehabil Neural Repair 2014; 29:472-82. [PMID: 25055836 DOI: 10.1177/1545968314543499] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND In preclinical stroke models, improvement in motor performance is associated with reorganization of cortical motor maps. However, the temporal relationship between performance gains and map plasticity is not clear. OBJECTIVE This study was designed to assess the effects of rehabilitative training on the temporal dynamics of behavioral and neurophysiological endpoints in a rat model of focal cortical infarct. METHODS Eight days after an ischemic infarct in primary motor cortex, adult rats received either rehabilitative training or were allowed to recover spontaneously. Motor performance and movement quality of the paretic forelimb was assessed on a skilled reach task. Intracortical microstimulation mapping procedures were conducted to assess the topography of spared forelimb representations either at the end of training (post-lesion day 18) or at the end of a 3-week follow-up period (post-lesion day 38). RESULTS Rats receiving rehabilitative training demonstrated more rapid improvement in motor performance and movement quality during the training period that persisted through the follow-up period. Motor maps in both groups were unusually small on post-lesion day 18. On post-lesion day 38, forelimb motor maps in the rehabilitative training group were significantly enlarged compared with the no-rehab group, and within the range of normal maps. CONCLUSIONS Postinfarct rehabilitative training rapidly improves motor performance and movement quality after an ischemic infarct in motor cortex. However, training-induced motor improvements are not reflected in spared motor maps until substantially later, suggesting that early motor training after stroke can help shape the evolving poststroke neural network.
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Affiliation(s)
| | | | - Scott Barbay
- University of Kansas Medical Center, Kansas City, KS, USA
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Abela E, Seiler A, Missimer JH, Federspiel A, Hess CW, Sturzenegger M, Weder BJ, Wiest R. Grey matter volumetric changes related to recovery from hand paresis after cortical sensorimotor stroke. Brain Struct Funct 2014; 220:2533-50. [PMID: 24906703 PMCID: PMC4549385 DOI: 10.1007/s00429-014-0804-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 05/17/2014] [Indexed: 12/29/2022]
Abstract
Preclinical studies using animal models have shown that grey matter plasticity in both perilesional and distant neural networks contributes to behavioural recovery of sensorimotor functions after ischaemic cortical stroke. Whether such morphological changes can be detected after human cortical stroke is not yet known, but this would be essential to better understand post-stroke brain architecture and its impact on recovery. Using serial behavioural and high-resolution magnetic resonance imaging (MRI) measurements, we tracked recovery of dexterous hand function in 28 patients with ischaemic stroke involving the primary sensorimotor cortices. We were able to classify three recovery subgroups (fast, slow, and poor) using response feature analysis of individual recovery curves. To detect areas with significant longitudinal grey matter volume (GMV) change, we performed tensor-based morphometry of MRI data acquired in the subacute phase, i.e. after the stage compromised by acute oedema and inflammation. We found significant GMV expansion in the perilesional premotor cortex, ipsilesional mediodorsal thalamus, and caudate nucleus, and GMV contraction in the contralesional cerebellum. According to an interaction model, patients with fast recovery had more perilesional than subcortical expansion, whereas the contrary was true for patients with impaired recovery. Also, there were significant voxel-wise correlations between motor performance and ipsilesional GMV contraction in the posterior parietal lobes and expansion in dorsolateral prefrontal cortex. In sum, perilesional GMV expansion is associated with successful recovery after cortical stroke, possibly reflecting the restructuring of local cortical networks. Distant changes within the prefrontal-striato-thalamic network are related to impaired recovery, probably indicating higher demands on cognitive control of motor behaviour.
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Affiliation(s)
- E. Abela
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital and University of Bern, Bern, Switzerland
- Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - A. Seiler
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital and University of Bern, Bern, Switzerland
| | - J. H. Missimer
- Laboratory of Biomolecular Research, Paul Scherrer Institute, Villigen, Switzerland
| | - A. Federspiel
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry and University of Bern, Bern, Switzerland
| | - C. W. Hess
- Department of Neurology, University Hospital Inselspital and University of Bern, Bern, Switzerland
| | - M. Sturzenegger
- Department of Neurology, University Hospital Inselspital and University of Bern, Bern, Switzerland
| | - B. J. Weder
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital and University of Bern, Bern, Switzerland
- Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - R. Wiest
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital and University of Bern, Bern, Switzerland
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Gindrat AD, Quairiaux C, Britz J, Brunet D, Lanz F, Michel CM, Rouiller EM. Whole-scalp EEG mapping of somatosensory evoked potentials in macaque monkeys. Brain Struct Funct 2014; 220:2121-42. [PMID: 24791748 PMCID: PMC4495608 DOI: 10.1007/s00429-014-0776-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 04/07/2014] [Indexed: 11/20/2022]
Abstract
High-density scalp EEG recordings are widely used to study whole-brain neuronal networks in humans non-invasively. Here, we validate EEG mapping of somatosensory evoked potentials (SSEPs) in macaque monkeys (Macaca fascicularis) for the long-term investigation of large-scale neuronal networks and their reorganisation after lesions requiring a craniotomy. SSEPs were acquired from 33 scalp electrodes in five adult anaesthetized animals after electrical median or tibial nerve stimulation. SSEP scalp potential maps were identified by cluster analysis and identified in individual recordings. A distributed, linear inverse solution was used to estimate the intracortical sources of the scalp potentials. SSEPs were characterised by a sequence of components with unique scalp topographies. Source analysis confirmed that median nerve SSEP component maps were in accordance with the somatotopic organisation of the sensorimotor cortex. Most importantly, SSEP recordings were stable both intra- and interindividually. We aim to apply this method to the study of recovery and reorganisation of large-scale neuronal networks following a focal cortical lesion requiring a craniotomy. As a prerequisite, the present study demonstrated that a 300-mm2 unilateral craniotomy over the sensorimotor cortex necessary to induce a cortical lesion, followed by bone flap repositioning, suture and gap plugging with calcium phosphate cement, did not induce major distortions of the SSEPs. In conclusion, SSEPs can be successfully and reproducibly recorded from high-density EEG caps in macaque monkeys before and after a craniotomy, opening new possibilities for the long-term follow-up of the cortical reorganisation of large-scale networks in macaque monkeys after a cortical lesion.
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Affiliation(s)
- Anne-Dominique Gindrat
- Domain of Physiology, Department of Medicine, Faculty of Sciences and Fribourg Center for Cognition, University of Fribourg, Chemin du Musée 5, 1700, Fribourg, Switzerland,
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Elder J, Cortes M, Rykman A, Hill J, Karuppagounder S, Edwards D, Ratan RR. The epigenetics of stroke recovery and rehabilitation: from polycomb to histone deacetylases. Neurotherapeutics 2013; 10:808-16. [PMID: 24092615 PMCID: PMC3805866 DOI: 10.1007/s13311-013-0224-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Classical de-afferentation studies, as well as experience-dependent visual plasticity paradigms, have confirmed that both the developing and adult nervous system are capable of unexpected levels of plasticity. This capacity is underscored by the significant spontaneous recovery that can occur in patients with mild-to-moderate impairment following stroke. An evolving model is that an interaction of biological and environmental factors during all epochs post-stroke influences the extent and quality of this plasticity. Here, we discuss data that have implicated specific epigenetic proteins as integrators of environmental influences in 3 aspects of stroke recovery: spontaneous impairment reduction in humans; peri-infarct rewiring in animals as a paradigm for developing therapeutically-driven impairment reduction beyond natural spontaneous recovery; and, finally, classical hippocampal learning and memory paradigms that are theoretically important in skill acquisition for both impairment reduction and compensatory strategies in the rehabilitation setting. Our discussion focuses primarily on B lymphoma Mo-MLV1 insertion region proteins of the polycomb repressive complex, alpha thalassemia/mental retardation syndrome X-linked chromatin remodeling factors, and the best known and most dynamic gene repressors, histone deacetylases. We will highlight exciting current data associated with these proteins and provide promising speculation about how they can be manipulated by drugs, biologics, or noninvasive stimulation for stroke recovery.
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Affiliation(s)
- Jessica Elder
- />Center for Stroke Recovery, Burke-Cornell Medical Research Institute, 785 Mamaroneck Avenue White Plains, New York, 10605 NY USA
- />Department of Epidemiology, Weill Medical College of Cornell University, New York, NY USA
| | - Mar Cortes
- />Center for Stroke Recovery, Burke-Cornell Medical Research Institute, 785 Mamaroneck Avenue White Plains, New York, 10605 NY USA
- />Department of Neurology, Weill Medical College of Cornell University, New York, NY USA
| | - Avrielle Rykman
- />Center for Stroke Recovery, Burke-Cornell Medical Research Institute, 785 Mamaroneck Avenue White Plains, New York, 10605 NY USA
| | - Justin Hill
- />Center for Stroke Recovery, Burke-Cornell Medical Research Institute, 785 Mamaroneck Avenue White Plains, New York, 10605 NY USA
- />Department of Neurology, Weill Medical College of Cornell University, New York, NY USA
- />Brain and Mind Research Institute, Weill Medical College of Cornell University, New York, NY USA
| | - Saravanan Karuppagounder
- />Center for Stroke Recovery, Burke-Cornell Medical Research Institute, 785 Mamaroneck Avenue White Plains, New York, 10605 NY USA
- />Brain and Mind Research Institute, Weill Medical College of Cornell University, New York, NY USA
| | - Dylan Edwards
- />Center for Stroke Recovery, Burke-Cornell Medical Research Institute, 785 Mamaroneck Avenue White Plains, New York, 10605 NY USA
- />Department of Neurology, Weill Medical College of Cornell University, New York, NY USA
| | - Rajiv R. Ratan
- />Center for Stroke Recovery, Burke-Cornell Medical Research Institute, 785 Mamaroneck Avenue White Plains, New York, 10605 NY USA
- />Department of Neurology, Weill Medical College of Cornell University, New York, NY USA
- />Brain and Mind Research Institute, Weill Medical College of Cornell University, New York, NY USA
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Hoogewoud F, Hamadjida A, Wyss AF, Mir A, Schwab ME, Belhaj-Saif A, Rouiller EM. Comparison of functional recovery of manual dexterity after unilateral spinal cord lesion or motor cortex lesion in adult macaque monkeys. Front Neurol 2013; 4:101. [PMID: 23885254 PMCID: PMC3717526 DOI: 10.3389/fneur.2013.00101] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Accepted: 07/09/2013] [Indexed: 02/06/2023] Open
Abstract
In relation to mechanisms involved in functional recovery of manual dexterity from cervical cord injury or from motor cortical injury, our goal was to determine whether the movements that characterize post-lesion functional recovery are comparable to original movement patterns or do monkeys adopt distinct strategies to compensate the deficits depending on the type of lesion? To this aim, data derived from earlier studies, using a skilled finger task (the modified Brinkman board from which pellets are retrieved from vertical or horizontal slots), in spinal cord and motor cortex injured monkeys were analyzed and compared. Twelve adult macaque monkeys were subjected to a hemi-section of the cervical cord (n = 6) or to a unilateral excitotoxic lesion of the hand representation in the primary motor cortex (n = 6). In addition, in each subgroup, one half of monkeys (n = 3) were treated for 30 days with a function blocking antibody against the neurite growth inhibitory protein Nogo-A, while the other half (n = 3) represented control animals. The motor deficits, and the extent and time course of functional recovery were assessed. For some of the parameters investigated (wrist angle for horizontal slots and movement types distribution for vertical slots after cervical injury; movement types distribution for horizontal slots after motor cortex lesion), post-lesion restoration of the original movement patterns (“true” recovery) led to a quantitatively better functional recovery. In the motor cortex lesion groups, pharmacological reversible inactivation experiments showed that the peri-lesion territory of the primary motor cortex or re-arranged, spared domain of the lesion zone, played a major role in the functional recovery, together with the ipsilesional intact premotor cortex.
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Affiliation(s)
- Florence Hoogewoud
- Domain of Physiology, Department of Medicine, Faculty of Sciences, Fribourg Cognition Center, University of Fribourg , Fribourg , Switzerland
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Large-scale reorganization of the somatosensory cortex of adult macaque monkeys revealed by fMRI. Brain Struct Funct 2013; 219:1305-20. [PMID: 23652854 DOI: 10.1007/s00429-013-0569-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 04/23/2013] [Indexed: 12/29/2022]
Abstract
Somatosensory cortex of adult primates undergoes topographic reorganization following spinal cord or peripheral nerve injuries. Electrophysiological studies in monkeys show that after chronic lesions of dorsal columns of the spinal cord at cervical levels, there is an expansion of face representation into the deafferented hand region of area 3b of cortex. However, these techniques can sample only a limited portion of the brain. In order to help understand mechanisms of brain reorganization use of noninvasive tools in non-human primate experimental model is important. Use of blood oxygen level dependent-functional magnetic resonance imaging (BOLD-fMRI) to study brain reorganization in non-human primates has been extremely limited. Here, we show that in monkeys with long-term unilateral lesions of the dorsal columns at cervical levels, tactile stimulation of the chin showed BOLD activation in the deafferented hand region of contralesional area 3b in the post-central gyrus. In a monkey with a partial lesion of the dorsal columns, stimulations of both hand and chin activated the partially deafferented hand region. We also show that the somatotopic organization in the non-deafferented ipsilesional somatosensory cortex remained normal.
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Craciunas SC, Brooks WM, Nudo RJ, Popescu EA, Choi IY, Lee P, Yeh HW, Savage CR, Cirstea CM. Motor and premotor cortices in subcortical stroke: proton magnetic resonance spectroscopy measures and arm motor impairment. Neurorehabil Neural Repair 2013; 27:411-20. [PMID: 23300210 DOI: 10.1177/1545968312469835] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although functional imaging and neurophysiological approaches reveal alterations in motor and premotor areas after stroke, insights into neurobiological events underlying these alterations are limited in human studies. OBJECTIVE We tested whether cerebral metabolites related to neuronal and glial compartments are altered in the hand representation in bilateral motor and premotor areas and correlated with distal and proximal arm motor impairment in hemiparetic persons. METHODS In 20 participants at >6 months postonset of a subcortical ischemic stroke and 16 age- and sex-matched healthy controls, the concentrations of N-acetylaspartate and myo-inositol were quantified by proton magnetic resonance spectroscopy. Regions of interest identified by functional magnetic resonance imaging included primary (M1), dorsal premotor (PMd), and supplementary (SMA) motor areas. Relationships between metabolite concentrations and distal (hand) and proximal (shoulder/elbow) motor impairment using Fugl-Meyer Upper Extremity (FMUE) subscores were explored. RESULTS N-Acetylaspartate was lower in M1 (P = .04) and SMA (P = .004) and myo-inositol was higher in M1 (P = .003) and PMd (P = .03) in the injured (ipsilesional) hemisphere after stroke compared with the left hemisphere in controls. N-Acetylaspartate in ipsilesional M1 was positively correlated with hand FMUE subscores (P = .04). Significant positive correlations were also found between N-acetylaspartate in ipsilesional M1, PMd, and SMA and in contralesional M1 and shoulder/elbow FMUE subscores (P = .02, .01, .02, and .02, respectively). CONCLUSIONS Our preliminary results demonstrated that proton magnetic resonance spectroscopy is a sensitive method to quantify relevant neuronal changes in spared motor cortex after stroke and consequently increase our knowledge of the factors leading from these changes to arm motor impairment.
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Abstract
Over the past two decades, results from neurophysiological studies in animal models and neuroimaging studies in human populations have converged along a common thread. Neuroplasticity in the remaining, intact tissue accompanies functional recovery after brain injury. Now, virtually every new therapeutic approach in postinjury rehabilitation relies on the fundamental principles of neuroplasticity for theoretical validity. In this chapter, the basic tenets of plasticity are outlined, and the neural substrates in the cerebral cortex that may subserve recovered functions are reviewed.
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Affiliation(s)
- Randolph J Nudo
- Department of Molecular and Integrative Physiology, KU Medical Center, Kansas City, KS, USA.
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Kaas JH, Stepniewska I, Gharbawie O. Cortical networks subserving upper limb movements in primates. Eur J Phys Rehabil Med 2012; 48:299-306. [PMID: 22407009 PMCID: PMC3695617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In all primates, the cortical control of hand and arm movements is initiated and controlled by a network of cortical regions including primary motor cortex (M1), premotor cortex (PMC), and posterior parietal cortex (PPC). These interconnected regions are influenced by inputs from especially visual and somatosensory cortical areas, and prefrontal cortex. Here we discuss recent evidence showing M1, PMC, and PPC can be subdivided into a number of functional zones or domains, including several that participate in guiding and controlling hand and arm movements. Functional zones can be defined by the movement sequences evoked by microstimulation within them, and functional zones related to the same type of movement in all three cortical regions are interconnected. The inactivation of a functional zone in each of the regions has a different impact on motor behavior. Finally, there is considerable plasticity within the networks so that behavioral recoveries can occur after damage to functional zones within a network.
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Affiliation(s)
- J H Kaas
- Department of Psychology, Vanderbilt University, Nashville, TN 37240-7817, USA.
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Moore TL, Killiany RJ, Pessina MA, Moss MB, Finklestein SP, Rosene DL. Recovery from ischemia in the middle-aged brain: a nonhuman primate model. Neurobiol Aging 2012; 33:619.e9-619.e24. [PMID: 21458887 PMCID: PMC3145025 DOI: 10.1016/j.neurobiolaging.2011.02.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 01/30/2011] [Accepted: 02/06/2011] [Indexed: 02/08/2023]
Abstract
Studies of recovery from stroke mainly utilize rodent models and focus primarily on young subjects despite the increased prevalence of stroke with age and the fact that recovery of function is more limited in the aged brain. In the present study, a nonhuman primate model of cortical ischemia was developed to allow the comparison of impairments in young and middle-aged monkeys. Animals were pretrained on a fine motor task of the hand and digits and then underwent a surgical procedure to map and lesion the hand-digit representation in the dominant motor cortex. Animals were retested until performance returned to preoperative levels. To assess the recovery of grasp patterns, performance was videotaped and rated using a scale adapted from human occupational therapy. Results demonstrated that the impaired hand recovers to baseline in young animals in 65-80 days and in middle-aged animals in 130-150 days. However, analysis of grasp patterns revealed that neither group recover preoperative finger thumb grasp patterns, rather they develop compensatory movements.
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Affiliation(s)
- Tara L Moore
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA.
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Activation likelihood estimation meta-analysis of motor-related neural activity after stroke. Neuroimage 2012; 59:2771-82. [DOI: 10.1016/j.neuroimage.2011.10.023] [Citation(s) in RCA: 228] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 10/06/2011] [Accepted: 10/07/2011] [Indexed: 01/27/2023] Open
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Cortical plasticity during motor learning and recovery after ischemic stroke. Neural Plast 2011; 2011:871296. [PMID: 22135758 PMCID: PMC3202122 DOI: 10.1155/2011/871296] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 07/18/2011] [Accepted: 08/22/2011] [Indexed: 11/17/2022] Open
Abstract
The motor system has the ability to adapt to environmental constraints and injury to itself. This adaptation is often referred to as a form of plasticity allowing for livelong acquisition of new movements and for recovery after stroke. We are not sure whether learning and recovery work via same or similar neural mechanisms. But, all these processes require widespread changes within the matrix of the brain. Here, basic mechanisms of these adaptations on the level of cortical circuitry and networks are reviewed. We focus on the motor cortices because their role in learning and recovery has been investigated more thoroughly than other brain regions.
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