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

Scientific Abstract

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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Gann MA, Paparella IA, Zich C, Grigoras IF, Huertas-Penen S, Rieger SW, Thielscher A, Sharott A, Stagg CJ, Schwab BC

Dual-site beta transcranial alternating current stimulation during a bimanual coordination task modulates functional connectivity between motor areas

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

Scientific Abstract

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.

Citation

2021. Fac Rev, 10:58.

DOI

10.12703/r/10-58

Free Full Text at Europe PMC

PMC8265564

Downloads

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Similar content

Preprint
Gann MA, Paparella IA, Zich C, Grigoras IF, Huertas-Penen S, Rieger SW, Thielscher A, Sharott A, Stagg CJ, Schwab BC

Dual-site beta transcranial alternating current stimulation during a bimanual coordination task modulates functional connectivity between motor areas