Steven C. Cramer, MD: Deep Brain Stimulation Promising in Post-Stroke Recovery
"An early-stage clinical trial has shown that deep brain stimulation (DBS) applied to the cerebellum may aid the recovery of upper limb function after stroke.
Researchers studied 12 people with moderate to severe upper extremity impairment after stroke who received DBS to the dentate nucleus (DN) of the cerebellum together with rehabilitation and found that 75% of the participants had meaningful response in regaining some function of their paralyzed arms.
PET revealed significant increments in brain metabolism around the part of the brain affected by the stroke.
"Our findings support the safety and feasibility of deep brain stimulation to the cerebellar dentate nucleus as a promising tool for modulation of late-stage neuroplasticity for functional recovery," the authors write.
"The results of the phase I study are promising; but more research is needed. The next step is a phase II clinical trial that is already enrolling patients at Cleveland Clinic," said senior author André Machado, MD, PhD, chairman, Neurological Institute and Charles and Christine Carroll Family Endowed Chair in Functional Neurosurgery, Cleveland Clinic.
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Commenting for Medscape Medical News, Steven Cramer, MD, MSc, Susan and David Wilstein Endowed Chair in Rehabilitation Medicine and professor, Department of Neurology, David Geffen School of Medicine at UCLA, noted that patients with post-stroke disability "have limited options in 2023, in terms of therapies to boost stroke recovery."
This study "provides exciting data on the safety and clinical efficacy of cerebellar deep brain stimulation, along with favorable PET biomarker data." But, as this is a "relatively small study with no control arm, this approach should now proceed to testing in a phase II controlled clinical trial," said Cramer, who is also the medical director of research at the California Rehabilitation Institute in Los Angeles and was not involved with the current study."
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