Neurochemical balance and inhibition at the subacute stage after stroke

Cirillo, John; Mooney, Ronan A.; Ackerley, Suzanne J.; Barber, P. Alan; Borges, Victor M.; Clarkson, Andrew N.; Mangold, Christine; Ren, April; Smith, Marie-Claire; Stinear, Cathy M.; Byblow, Winston D.

doi:10.1152/jn.00561.2019

Cited by 20 publications

(18 citation statements)

References 84 publications

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“…Interpretation of this result is not simple: the authors also reported higher GABA B activity (LICI) in both hemispheres compared with controls, in contradiction to previous studies 53 , 54 . Compared with controls, there was also an increase in 1 ms SICI, a putative measure of extra-synaptic activity, in the ipsilesional hemisphere at 6 weeks post-stroke, though this was not present at either 2 weeks or 12 weeks post-stroke 52 .…”

Section: Excitation–inhibition Balance In Stroke Pathophysiologymentioning

confidence: 70%

“…Furthermore, in a recent relatively small study, MRS-derived measurements of [GABA] in ipsilesional M1 were not significantly different from those in healthy age-matched controls, but [GABA] in the contralesional M1 was significantly lower, leading to an overall higher excitation–inhibition ratio 52 . Interpretation of this result is not simple: the authors also reported higher GABA B activity (LICI) in both hemispheres compared with controls, in contradiction to previous studies 53 , 54 .…”

Section: Excitation–inhibition Balance In Stroke Pathophysiologymentioning

confidence: 71%

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Recent advances in the role of excitation–inhibition balance in motor recovery post-stroke

Grigoras¹,

Stagg²

2021

Fac Rev

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Stroke affects millions of people worldwide each year, and stroke survivors are often left with motor deficits. Current therapies to improve these functional deficits are limited, making it a priority to better understand the pathophysiology of stroke recovery and find novel adjuvant options. The excitation–inhibition balance undergoes significant changes post-stroke, and the inhibitory neurotransmitter γ-aminobutyric acid (GABA) appears to play an important role in stroke recovery. In this review, we summarise the most recent studies investigating GABAergic inhibition at different stages of stroke. We discuss the proposed role of GABA in counteracting glutamate-mediated excitotoxicity in hyperacute stroke as well as the evidence linking decreased GABAergic inhibition to increased neuronal plasticity in early stroke. Then, we discuss two types of interventions that aim to modulate the excitation–inhibition balance to improve functional outcomes in stroke survivors: non-invasive brain stimulation (NIBS) and pharmacological interventions. Finding the optimal NIBS administration or adjuvant pharmacological therapies would represent an important contribution to the currently scarce therapy options.

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Section: Excitation–inhibition Balance In Stroke Pathophysiologymentioning

confidence: 70%

Section: Excitation–inhibition Balance In Stroke Pathophysiologymentioning

confidence: 71%

Recent advances in the role of excitation–inhibition balance in motor recovery post-stroke

Grigoras¹,

Stagg²

2021

Fac Rev

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“…The study data were drawn from a pool of patients admitted to our hospital between December 2009 and July 2019, who were enrolled in one of five different longitudinal studies ( Stinear et al, 2014 , Stinear et al, 2017a , Stinear et al, 2017b , Cirillo et al, 2020 , two unpublished). Exclusion criteria for all studies were age less than 18 years, bilateral or cerebellar stroke, and impaired cognition or communication precluding informed consent.…”

Section: Methodsmentioning

confidence: 99%

Investigating the structure-function relationship of the corticomotor system early after stroke using machine learning

Chong

Wang

Borges

et al. 2022

NeuroImage: Clinical

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“…Motor thresholds reflect the strength and size of the most excitable elements of the muscle representation in the primary motor area, which include the availability of excitatory neurotransmitters (e.g., glutamate) and their receptors and function of ion channels in cortical and spinal neuron populations [10]. Inability to obtain a MEP during TMS suggests poorer integrity of the corticospinal tract [12]. In this way, an increase in motor threshold (i.e., the primary motor area requires higher stimulation intensity to elicit a MEP) indicates decreased CSE.…”

Section: Motor Thresholdsmentioning

confidence: 99%

Probing the Brain–Body Connection Using Transcranial Magnetic Stimulation (TMS): Validating a Promising Tool to Provide Biomarkers of Neuroplasticity and Central Nervous System Function

et al. 2021

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Transcranial magnetic stimulation (TMS) is a non-invasive method used to investigate neurophysiological integrity of the human neuromotor system. We describe in detail, the methodology of a single pulse TMS protocol that was performed in a large cohort of people (n = 110) with multiple sclerosis (MS). The aim was to establish and validate a core-set of TMS variables that predicted typical MS clinical outcomes: walking speed, hand dexterity, fatigue, and cognitive processing speed. We provide a brief and simple methodological pipeline to examine excitatory and inhibitory corticospinal mechanisms in MS that map to clinical status. Delayed and longer ipsilateral silent period (a measure of transcallosal inhibition; the influence of one brain hemisphere’s activity over the other), longer cortical silent period (suggestive of greater corticospinal inhibition via GABA) and higher resting motor threshold (lower corticospinal excitability) most strongly related to clinical outcomes, especially when measured in the hemisphere corresponding to the weaker hand. Greater interhemispheric asymmetry (imbalance between hemispheres) correlated with poorer performance in the greatest number of clinical outcomes. We also show, not surprisingly, that TMS variables related more strongly to motor outcomes than non-motor outcomes. As it was validated in a large sample of patients with varying severities of central nervous system dysfunction, the protocol described herein can be used by investigators and clinicians alike to investigate the role of TMS as a biomarker in MS and other central nervous system disorders.

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Neurochemical balance and inhibition at the subacute stage after stroke

Cited by 20 publications

References 84 publications

Recent advances in the role of excitation–inhibition balance in motor recovery post-stroke

Recent advances in the role of excitation–inhibition balance in motor recovery post-stroke

Investigating the structure-function relationship of the corticomotor system early after stroke using machine learning

Probing the Brain–Body Connection Using Transcranial Magnetic Stimulation (TMS): Validating a Promising Tool to Provide Biomarkers of Neuroplasticity and Central Nervous System Function

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