# Effects of Cortical Stimulation on Motor Recovery

> **NIH NIH K00** · MEDICAL UNIVERSITY OF SOUTH CAROLINA · 2020 · $76,900

## Abstract

Effects of Cortical Stimulation on Motor Recovery
 Cortical stimulation (CS) techniques, such as epidural cortical stimulation (ECS)
and repeated transcranial magnetic stimulation (rTMS), are emerging as potential
therapeutic tools to enhance the efficacy of post-stroke rehabilitation. Excitatory
electrical cortical stimulation (eCS) or repeated Transcranial Magnetic Stimulation
(rTMS) over the infarcted motor cortex, or disruptive low-frequency rTMS over the
contralateral non-infarcted motor cortex, can lead to motor improvements of the paretic
limb. Current theories suggest that cortical stimulation following ischemic damage “re-
balances” interhemispheric activity between the non-infarcted and infarcted hemispheres
interconnected via reciprocal excitatory circuits. In humans, facilitatory stimulation (high-
frequency) ECS or rTMS over the infarcted motor cortex or disruptive stimulation (low-
frequency) rTMS has been shown to improve performance of the paretic side; however,
several studies also fail to support these findings. In rats, we and others have found that
high-frequency (50Hz – 100Hz) ECS over the peri-lesion motor cortex following a focal,
moderate stroke concurrent with motor rehabilitative training (RT), robustly improves
functional motor recovery. Peri-infarct ECS+RT also results in functional and structural
neural plasticity in the remaining motor cortex compared to RT alone. However, following
severe strokes or controlled cortical impacts, a model of moderate to severe TBI, ipsi-
injury high-frequency ECS+RT sub-optimally improves recovery compared to RT alone.
We hypothesize that following moderate to severe damage to the motor cortex, low-
frequency stimulation over the non-infarcted motor cortex concurrent with RT will be
more effective at improving impaired motor function compared to high-frequency ipsi-
injury ECS+RT or RT alone. BDNF binding to TrkB is necessary and sufficient to
improve motor function and drive neural plasticity after stroke. CS+Rt also provides
motor recovery through CS's ability to increase BDNF/TrkB signaling. We also
hypothesize that this facilitation may be sensitive to endogenous BDNF/TrkB activity
altered by age, and that pharmacological enhancement of TrkB signaling will maximize
CS effects in aged animals.These studies will lay the foundation to better understand the
lack of consensus across studies and to begin investigating the mechanisms underlying
CS effects in stroke recovery.

## Key facts

- **NIH application ID:** 10066689
- **Project number:** 4K00NS105220-03
- **Recipient organization:** MEDICAL UNIVERSITY OF SOUTH CAROLINA
- **Principal Investigator:** Serena-Kaye Kinley-Cooper Sims
- **Activity code:** K00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $76,900
- **Award type:** 4N
- **Project period:** 2018-07-31 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10066689

## Citation

> US National Institutes of Health, RePORTER application 10066689, Effects of Cortical Stimulation on Motor Recovery (4K00NS105220-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10066689. Licensed CC0.

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