Therapeutic interventions for post-stroke rehabilitation

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Stroke remains one of the leading causes of death and disability in the USA. The principal objective of the current proposal is to test the efficacy of combined therapeutic hypothermia with whole body vibration on post-stroke cognitive improvement using a model of stroke in aged rats. There are three main types of stroke: transient ischemic attack, hemorrhagic stroke and acute ischemic stroke, with the latter constituting 87% of total stroke cases. Currently, the only clinical therapies available for acute ischemic stroke are thrombolysis (tPA) and mechanical endovascular recanalization, both of which have only limited applications in a small number of patients. Cognitive decline is one of the most significant problems affecting almost two-thirds of stroke survivors for up to 6 years post-stroke. Therefore, identifying novel neuroprotective strategies to improve post-stroke cognition remains a high priority. In animal models of stroke (transient middle cerebral artery occlusion – tMCAO), behavioral studies yield evidence of deficits in spatial, non-spatial, and motor learning. These deficits can be minimized in middle-aged rat models of stroke with noninvasive whole body vibration (WBV) therapy. Likewise, long-standing research from our laboratory shows that therapeutic hypothermia (TH) is a potent neuroprotective therapy in experimental cerebral ischemia with multiple effects at several stages of the ischemic cascade. The translational goal of our successful study will be to identify a novel therapeutic approach for stroke rehabilitation that can be moved quickly to testing in clinical trials.