Modulation of Cerebellar Cortical Plasticity Using Low-Intensity Focused Ultrasound for Poststroke Sensorimotor Function Recovery
Modulation of Cerebellar Cortical Plasticity Using Low-Intensity Focused Ultrasound for Poststroke Sensorimotor Function Recovery
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DOI：
10.1177/1545968318790022
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发表时间：
2018-09-01
影响因子：
4.2
通讯作者：
Kim, Hyungmin
中科院分区：
文献类型：
--
作者：
Baek, Hongchae;Pahk, Ki Joo;Kim, Hyungmin
背景中风通过影响双侧运动活动，通过大脑半球间的连接影响广泛的大脑区域。几种非侵入性脑刺激技术已经证明了它们通过操纵替代通路的神经活动来补偿功能损失的能力。在过去的几十年里，脑刺激疗法已经在调节皮质兴奋性的理论框架内进行了调整，以增强中风后的适应性可塑性。Objective.然而，考虑到动物和人类大脑皮层结构之间的巨大差异，重要的是从人类翻译的更高阶大脑结构开始接近特定的神经元目标。本研究的重点是刺激小脑外侧核（LCN），它将主要的小脑输出发送到广泛的皮质区域。方法.在这项研究中，在体内中风小鼠LCN暴露于低强度聚焦超声（LIFU）。LIFU暴露后，动物进行4周的康复训练。结果在小脑LIFU会话期间，运动诱发电位（MEP）伴随兴奋性声处理参数在两个前肢中产生。脑卒中后第1天LCN刺激组与未刺激组相比，感觉运动恢复明显增强。2次行为学测试均能维持4周的恢复。此外，我们观察到中风后3天受影响半球的脑水肿和组织肿胀水平显著降低。结论.这项研究提供了第一个证据表明，LIFU诱导的小脑调制可能是中风后恢复的重要策略。然而，为了充分证实LIFU对卒中后恢复的影响，需要进行更长时间的随访研究。
Background. Stroke affects widespread brain regions through interhemispheric connections by influencing bilateral motor activity. Several noninvasive brain stimulation techniques have proved their capacity to compensate the functional loss by manipulating the neural activity of alternative pathways. Over the past few decades, brain stimulation therapies have been tailored within the theoretical framework of modulation of cortical excitability to enhance adaptive plasticity after stroke. Objective. However, considering the vast difference between animal and human cerebral cortical structures, it is important to approach specific neuronal target starting from the higher order brain structure for human translation. The present study focuses on stimulating the lateral cerebellar nucleus (LCN), which sends major cerebellar output to extensive cortical regions. Methods. In this study, in vivo stroke mouse LCN was exposed to low-intensity focused ultrasound (LIFU). After the LIFU exposure, animals underwent 4 weeks of rehabilitative training. Results. During the cerebellar LIFU session, motor-evoked potentials (MEPs) were generated in both forelimbs accompanying excitatory sonication parameter. LCN stimulation group on day I after stroke significantly enhanced sensorimotor recovery compared with the group without stimulation. The recovery has maintained for a 4-week period in 2 behavior tests. Furthermore, we observed a significantly decreased level of brain edema and tissue swelling in the affected hemisphere 3 days after the stroke. Conclusions. This study provides the first evidence showing that LIFU-induced cerebellar modulation could be an important strategy for poststroke recovery. A longer follow-up study is, however, necessary in order to fully confirm the effects of LIFU on poststroke recovery.