Combination of Cortical Stimulation with Other Therapies

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Motor rehabilitation capitalizes upon mechanisms of motor learning and it is now very well-established that motor learning induces major changes in neural connectivity and activity patterns in the brains of adult animals, including humans. This makes motor rehabilitation extremely well suited to promote the formation of functionally appropriate neural connectivity after motor cortical strokes, but it is likely to be most effective when used in combination with other treatment approaches. Converging evidence from the research teams of this program indicate that focal cortical electrical stimulation (CS) enhances the potency of rehabilitative training (RT). The type of RT used is likely to be a critical variable in the efficacy of CS/RT and, to date, only one type of RT has been examined. Project 2 will use a rat model of focal ischemic damage to the sensorimotor cortex to optimize the motor rehabilitation that is combined with epidural CS. The specific aims are to (1) assess the efficacy of combining the optimized CS/RT with a rodent version of constraint-induced movement therapy (2) determine the optimal motor rehabilitative training regime to combine with CS, and (3) determine whether enhanced performance produced by CS/RT is long-lasting after the cessation of the treatment.