Effects of Subdural Monopolar Cortical Stimulation Paired with Rehabilitative Training on Behavioral and Neurophysiological Recovery after Cortical Ischemic Stroke in Adult Squirrel Monkeys

Erik J. Plautz, Scott Barbay, Shawn B. Frost, Elena V. Zoubina, Ann M. Stowe, N. U M A Dancause, Ines Eisner-Janowicz, Scott D. Bury, Michael D. Taylor, Randolph J. Nudo

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background. Cortical stimulation (CS) combined with rehabilitative training (RT) has proven effective for enhancing poststroke functional recovery in rats, but human clinical trials have had mixed outcomes. Objective. To assess the efficacy of CS/RT versus RT in a nonhuman primate model of cortical ischemic stroke. Methods. Squirrel monkeys learned a pellet retrieval task, then received an infarct to the distal forelimb (DFL) representation of primary motor cortex. A subdural monopolar electrode was implanted over the spared DFL representation in dorsal premotor cortex (PMD). Seven weeks postinfarct, monkeys underwent 4 to 6 weeks of RT (n = 8) or CS/RT (n = 7; 100 Hz, cathodal current) therapy. Behavioral performance was assessed before and after infarct, prior to therapy, and 1 and 12 weeks posttherapy (follow-up). The primary outcome measure was motor performance at 1 week posttherapy. Secondary outcomes included follow-up performance at 12 weeks and treatment-related changes in neurophysiological maps of spared DFL representations. Results. While postinfarct performance deficits were found in all monkeys, both groups demonstrated similar recovery profiles, with no difference in motor recovery between the RT and CS/RT groups. Posttherapy, PMD DFL area was significantly expanded in the RT group but not the CS/RT group. A significant relationship was found between motor recovery and DFL expansion in premotor cortex. Conclusions. Results suggest that the specific parameters utilized here were not optimal for promoting behavioral recovery in nonhuman primates. Though CS/RT has consistently shown efficacy in rat stroke models, the present finding has cautionary implications for translation of CS/RT therapy to clinical populations.

Original languageEnglish (US)
Pages (from-to)159-172
Number of pages14
JournalNeurorehabilitation and Neural Repair
Volume30
Issue number2
DOIs
StatePublished - Feb 1 2016

Keywords

  • implanted stimulation electrodes
  • neuronal plasticity
  • premotor cortex
  • primary motor cortex
  • primate

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology

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