Targeting interhemispheric inhibition with neuromodulation to enhance stroke rehabilitation

Boddington, Laura; Reynolds, John N. J.

doi:10.1016/j.brs.2017.01.006

Cited by 147 publications

(99 citation statements)

References 123 publications

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“…For example, tDCS had been used in stroke rehabilitation by inhibiting the unaffected hemisphere or facilitating the excitability of the affected hemisphere according to the interhemispheric competition model of the stroke . However, the degree to which asymmetric interhemispheric inhibition impacts on stroke recovery is controversial . There seems to be an appealing and intuitive link between functional lateralization and stimulation effect.…”

Section: Introductionmentioning

confidence: 99%

“…[3] However, the degree to which asymmetric interhemispheric inhibition impacts on stroke recovery is controversial. [4,5] There seems to be an appealing and intuitive link between functional lateralization and stimulation effect. However, the nature and direction of this link are poorly understood, especially in the high-level cognition, such as social cognitive processing.…”

Section: Introductionmentioning

confidence: 99%

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Neural and Psychological Predictors of Cognitive Enhancement and Impairment from Neurostimulation

et al. 2020

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Modulating the temporoparietal junction (TPJ), especially the right counterpart, shows promises in enhancing social cognitive ability. However, it is ambiguous whether the functional lateralization of TPJ determines people's responsiveness to brain stimulation. Here, this issue is investigated with an individual difference approach. Forty‐five participants attended three sessions of transcranial direct current stimulation (tDCS) experiments and one neuroimaging session. The results support the symmetric mechanism of left and right TPJ stimulation. First, the left and right TPJ stimulation effect are comparable in the group‐level analysis. Second, the individual‐level analysis reveals that a less right‐lateralized TPJ is associated with a higher level of responsiveness. Participants could be classified into positive responders showing cognitive enhancement and negative responders showing cognitive impairment due to stimulation. The positive responders show weaker connectivity between bilateral TPJ and the medial prefrontal cortex, which mediates the prediction of offline responsiveness by the lateralization and the social‐related trait. These findings call for a better characterization and predictive models for whom tDCS should be used for, and highlight the necessity and feasibility of prestimulation screening.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neural and Psychological Predictors of Cognitive Enhancement and Impairment from Neurostimulation

et al. 2020

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“…LI thus has been used an indicator of neurological impairment and the therapeutic target for stroke [79,84e86]. Clinical brain stimulation techniques, e.g., TMS and tDCS, have been explored as a means of restoring this interhemispheric balance, though the underlying cellular mechanism of IHI remains unclear and should be further studied [85,87,88].…”

Section: Discussionmentioning

confidence: 99%

Optogenetic translocation of protons out of penumbral neurons is protective in a rodent model of focal cerebral ischemia

Yao

et al. 2020

Brain Stimulation

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a b s t r a c tBackground: Intracellular acidosis in the ischemic penumbra can contribute to further cell death, effectively enlarging the infarct core. Restoring the acid-base balance may enhance tissue survivability after cerebral ischemia.Objective: This study investigated whether translocating protons out of penumbral neurons could mitigate tissue acidification and induce neuroprotection in a rodent model of acute cerebral ischemia. Methods: We modulated the penumbral neurons via a light-driven pump to translocate protons out (i.e., archaerhodopsin/ArchT group) or into (i.e., channelrhodopsin-2/ChR2 group) neurons after focal cerebral ischemia in rats. Intracellular pH values were imaged via neutral red (NR) fluorescence and cerebral blood flow (CBF) was monitored through laser speckle contrast imaging (LSCI). Global CBF responses to electrical stimulation of the hindlimbs were obtained 24 h and 48 h after ischemia to assess neurological function. Behavioral and histological outcomes were evaluated 48 h after ischemia. A control group without gene modification was included. Results: The reduction of relative pH (R pH ), the amplitude of negative peak of hypoemic response (R NP ) and the hemispheric lateralization index (LI) in ArchT group were significantly less than those of the ChR2 or control group. Moreover, R pH was strongly correlated with R NP (r ¼ 0.60) and LI (r 24h ¼ 0.80, r 48h ¼ 0.59). In addition, behavioral and histological results supported a neuroprotective effect of countering neuronal acidosis in penumbra through optogenetic stimulation. Conclusion(s): These results indicate that countering intracellular acidosis by optogenetically translocating protons out of penumbral neurons during the acute ischemic stage could induce protection after ischemic brain injury.

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“…When reduced motor inhibition induces unmasking of normally suppressed or inhibited pathways, the unaffected hemisphere is modulated functionally by activating cortico-cortical connections [ 16 , 17 ]. Excessive levels of inhibitory stimuli interfere with the reorganization around the damaged site, and limit the motor function recovery [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Changes in Intracortical Excitability of Affected and Unaffected Hemispheres After Stroke Evaluated by Paired-Pulse Transcranial Magnetic Stimulation

et al. 2018

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ObjectiveTo assess the altered pattern of intracortical excitability of the affected and unaffected hemispheres in stroke patients using paired-pulse transcranial magnetic stimulation (TMS).MethodsWe evaluated intracortical inhibition (ICI) and intracortical facilitation (ICF) in both hemispheres at acute and subacute stages of 103 stroke patients using paired-pulse TMS. The patients were divided into two groups: mild-to-moderate patients whose motor evoked potential (MEP) was recorded in the affected hemisphere; and severe patients whose MEP was not recorded in the affected hemisphere.ResultsIn mild-to-moderate patients, the value of ICI in the affected hemisphere was increased from 70.3% to 77.9% and the value of ICI in the unaffected hemisphere was decreased from 74.8% to 70.3% with eventual progression in acute to subacute stages of stroke. In severe patients, the value of ICI in the unaffected hemisphere was increased from 65.4% to 75.6%. The changes in ICF were not significantly different in this study.ConclusionWe conclude that the unaffected hemisphere was more disinhibited than the affected hemisphere in acute phase of mild-to-moderate stroke, and the affected hemisphere was more disinhibited in the subacute stage. The unaffected hemisphere was inhibited in severe cases in acute-to-subacute phases of stroke. This finding facilitates appropriate neuromodulation of acute-to-subacute phases in mild-to-severe stroke patients.

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Targeting interhemispheric inhibition with neuromodulation to enhance stroke rehabilitation

Cited by 147 publications

References 123 publications

Neural and Psychological Predictors of Cognitive Enhancement and Impairment from Neurostimulation

Neural and Psychological Predictors of Cognitive Enhancement and Impairment from Neurostimulation

Optogenetic translocation of protons out of penumbral neurons is protective in a rodent model of focal cerebral ischemia

Changes in Intracortical Excitability of Affected and Unaffected Hemispheres After Stroke Evaluated by Paired-Pulse Transcranial Magnetic Stimulation

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