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Oishi R, Takeda I, Ode Y, Okada Y, Kato D, Nakashima H, Imagama S, Wake H. Neuromodulation with transcranial direct current stimulation contributes to motor function recovery via microglia in spinal cord injury. Sci Rep 2024; 14:18031. [PMID: 39098975 PMCID: PMC11298548 DOI: 10.1038/s41598-024-69127-7] [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: 10/11/2023] [Accepted: 07/31/2024] [Indexed: 08/06/2024] Open
Abstract
Spinal cord injury (SCI) is damage or trauma to the spinal cord, which often results in loss of function, sensation, or mobility below the injury site. Transcranial direct current stimulation (tDCS) is a non-invasive and affordable brain stimulation technique used to modulate neuronal circuits, which changes the morphology and activity of microglia in the cerebral cortex. However, whether similar morphological changes can be observed in the spinal cord remains unclear. Therefore, we evaluated neuronal population activity in layer 5 (L5) of M1 following SCI and investigated whether changes in the activities of L5 neurons affect microglia-axon interactions using C57BL/6J mice. We discovered that L5 of the primary motor cortex (corticospinal neurons) exhibited reduced synchronized activity after SCI that correlates with microglial morphology, which was recovered using tDCS. This indicates that tDCS promotes changes in the morphological properties and recovery of microglia after SCI. Combining immunotherapy with tDCS may be effective in treating SCI.
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Affiliation(s)
- Ryotaro Oishi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
- Department of Anatomy and Molecular Cell Biology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Ikuko Takeda
- Department of Anatomy and Molecular Cell Biology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
- Division of Multicellular Circuit Dynamics, National Institute for Physiological Sciences, Myodaiji, Okazaki, 444-8585, Japan
| | - Yukihito Ode
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
- Department of Anatomy and Molecular Cell Biology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Yuya Okada
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
- Department of Anatomy and Molecular Cell Biology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Daisuke Kato
- Department of Anatomy and Molecular Cell Biology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Hiroaki Nakashima
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Hiroaki Wake
- Department of Anatomy and Molecular Cell Biology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan.
- Division of Multicellular Circuit Dynamics, National Institute for Physiological Sciences, Myodaiji, Okazaki, 444-8585, Japan.
- Center for Optical Scattering Image Science, Kobe University, Kobe, Japan.
- Department of Physiological Sciences, Graduate University for Advanced Studies, SOKENDAI, Shonan, Hayama, Kanagawa, 240-0193, Japan.
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, 4-1-8 Honcho, Kawaguchi, Saitama, 332-0012, Japan.
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Salazar CA, Feng W, Bonilha L, Kautz S, Jensen JH, George MS, Rowland NC. Transcranial Direct Current Stimulation for Chronic Stroke: Is Neuroimaging the Answer to the Next Leap Forward? J Clin Med 2023; 12:2601. [PMID: 37048684 PMCID: PMC10094806 DOI: 10.3390/jcm12072601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023] Open
Abstract
During rehabilitation, a large proportion of stroke patients either plateau or begin to lose motor skills. By priming the motor system, transcranial direct current stimulation (tDCS) is a promising clinical adjunct that could augment the gains acquired during therapy sessions. However, the extent to which patients show improvements following tDCS is highly variable. This variability may be due to heterogeneity in regions of cortical infarct, descending motor tract injury, and/or connectivity changes, all factors that require neuroimaging for precise quantification and that affect the actual amount and location of current delivery. If the relationship between these factors and tDCS efficacy were clarified, recovery from stroke using tDCS might be become more predictable. This review provides a comprehensive summary and timeline of the development of tDCS for stroke from the viewpoint of neuroimaging. Both animal and human studies that have explored detailed aspects of anatomy, connectivity, and brain activation dynamics relevant to tDCS are discussed. Selected computational works are also included to demonstrate how sophisticated strategies for reducing variable effects of tDCS, including electric field modeling, are moving the field ever closer towards the goal of personalizing tDCS for each individual. Finally, larger and more comprehensive randomized controlled trials involving tDCS for chronic stroke recovery are underway that likely will shed light on how specific tDCS parameters, such as dose, affect stroke outcomes. The success of these collective efforts will determine whether tDCS for chronic stroke gains regulatory approval and becomes clinical practice in the future.
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Affiliation(s)
- Claudia A. Salazar
- Department of Neurosurgery, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
- Center for Biomedical Imaging, University of South Carolina, Columbia, SC 29208, USA
- Department of Neuroscience, College of Graduate Studies, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Wuwei Feng
- Department of Neurology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Leonardo Bonilha
- Department of Neurology, College of Medicine, Emory University, Atlanta, GA 30322, USA
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Steven Kautz
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA
| | - Jens H. Jensen
- Center for Biomedical Imaging, University of South Carolina, Columbia, SC 29208, USA
- Department of Neuroscience, College of Graduate Studies, Medical University of South Carolina, Charleston, SC 29425, USA
- Department of Radiology and Radiological Science, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Mark S. George
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Nathan C. Rowland
- Department of Neurosurgery, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
- Center for Biomedical Imaging, University of South Carolina, Columbia, SC 29208, USA
- Department of Neuroscience, College of Graduate Studies, Medical University of South Carolina, Charleston, SC 29425, USA
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA
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Personalized Approaches to Stroke: One Step Forward for Functional Recovery of Stroke Patients. J Pers Med 2022; 12:jpm12050822. [PMID: 35629244 PMCID: PMC9148160 DOI: 10.3390/jpm12050822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
Recent advances in diagnoses, management, and rehabilitation have had a significant impact to reduce mortality and functional recovery in stroke patients. In spite of these medical advances, many stroke survivors still suffer from significant disabilities. Stroke is a complex disease caused by a combination of multiple risk factors. Therefore, personalized medicine is more important than any other field to overcome the limitations of current stroke management and rehabilitation. It is necessary to apply accurate evaluation for functions and a personalized approach in consideration of various characteristics of each stroke patient to improve function. The objective of this Special Issue is to inform the recent scientific knowledge, current limitations, and challenges for an individually tailored strategy in the areas of diagnosis, treatment, and rehabilitation of stroke. A multidisciplinary approach and research will be strongly encouraged for personalized medicine in the field of stroke treatment and rehabilitation.
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