Multidimensional and multi-scale analysis of the rehabilitation after stroke
Neurorehabilitative therapy is the most effective treatment for promoting the recovery of motor deficits in stroke patients.
Nevertheless, the neural basis underlying the recovery associated with rehabilitative interventions is debated.
Here, we investigated the multiple facets of cortical remodeling induced by combined pharmacological and motor training rehabilitative therapy after stroke.
Using longitudinal imaging of cortical activity in the peri-infarct area during motor training, we demonstrated the progressive restoration of cortical motor maps and of cortical activity as assessed by calcium imaging.
The functional connectivity between the spared cortex and the injured hemisphere was reinforced by rehabilitation, as demonstrated by our simultaneous optogenetic and calcium imaging approach.
Additionally, two-photon microscopy revealed a significant increase in vascular density and the stabilization of peri-infarct area synaptic level circuitry following rehabilitation.
Finally, whole brain vasculature reconstruction with light sheet microscopy imaging on cleared tissues, reveals the effects of rehab on vasculature organization in the peri-lesioned area.
The present work, by combining imaging techniques and the manipulation of neuronal activity, provides the first in vivo evidence of the mechanism by which rehabilitation shapes cortical plasticity after stroke.