# Transcranial Electrical Stimulation Promotes Cerebral Blood Flow, Enhancing Cognitive and Motor Recovery with Concurrent Rehab Training after Stroke

> **NIH VA I21** · DURHAM VA MEDICAL CENTER · 2024 · —

## Abstract

Ischemic stroke is a leading cause of death and serious long-term disability with motor impairment
as one of most common complication. Despite significant efforts, effective motor rehabilitation
strategies are still lacking. Transcranial alternating current stimulation (tACS) is a promising non-
invasive brain stimulation technique that combined with motor task training can facilitates
neuroplasticity and motor learning. However, limited understanding of the neurophysiological
effects, dose-response relationship, post-stroke motor outcome, safety, and tolerability issue have
prevented the successful application of tACS in rehabilitation settings. Individual variation of
collateral vessel density it is a critical factor that influence stroke outcome, but likely alters cerebral
blood flow (CBF) and activity-dependent plasticity mechanism that support circuit remodeling and
motor recovery after stroke. Therefore, we hypothesize that monitoring the interaction between
motor rehab training, tACS, and CBF recovery can advance post-stroke rehab intervention. To
address the role of the collateral circulation and CBF in recovery, we will assess the ability of
tACS (10Hz) to improve motor performance in isogenic strains of mice (males and females at 6
and 12 months of age) and compare it with mice without extensive collateral vasculature. Specific
Aim 1: During the four weeks of post-stroke intervention, we will assess the effects of local CBF
increase in response to tACS in conjunction with motor rehabilitation training on long-term motor
function using local CBF as surrogate maker of neuronal activation and dose-response
relationship in WT and collateral-deficient Rabep2-KO mice. Specific Aim 2. To assess the effect
of tACS neuronal and vascular plasticity in relationship with stroke outcome We will compare the
effects of the motor rehabilitation protocol with and without tACS on post-stroke brain
neuroplasticity in relationship to neurological and cognitive function in WT and Rabep2-KO mice.
For our model of stroke, we will use a distal middle cerebral artery occlusion (MCAO) plus
ipsilateral common carotid artery ligation (CCA) model with reperfusion after 24hr, which is a
suitable model for the study of long-term stroke outcomes in young adult and older mice. This, in
turn, results in consistent infarct size and significant long-term sensorimotor impairment. Rehab
training h to mimic traditional early upper limb motor recovery +/-tACS, (2 dosing groups) will start
72hr after stroke. Long-term recovery mechanisms to be studied include an assessment of motor
performance, which will be correlated with post-stroke neurovascular plasticity, neurological and
cognitive function. Successful completion of this study will determine treatment effect of TACS on
long-term post-stroke motor recovery and utility of CBF as intracranial biomarker for determining
effective stimulation protocol.

## Key facts

- **NIH application ID:** 10869876
- **Project number:** 5I21RX003765-03
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Francesca Galeffi
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2022-04-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10869876

## Citation

> US National Institutes of Health, RePORTER application 10869876, Transcranial Electrical Stimulation Promotes Cerebral Blood Flow, Enhancing Cognitive and Motor Recovery with Concurrent Rehab Training after Stroke (5I21RX003765-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10869876. Licensed CC0.

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