Enhancing Recovery in Stroke Patients Through Innovative Therapies

The Role of Cerebellar Stimulation in Stroke Rehabilitation

Cerebellar stimulation, particularly through techniques like intermittent theta-burst stimulation (iTBS), has been shown to enhance motor and cognitive functions in stroke patients (Xu et al., 2025). The cerebellum plays a crucial role in motor control, and its modulation can significantly influence recovery outcomes. iTBS targeting the cerebellum has demonstrated efficacy in activating specific regions of the cerebral cortex responsible for motor learning and cognitive processes.

In a preliminary study, fNIRS was employed to evaluate the immediate effects of cerebellar iTBS on cortical activation in stroke patients. Results indicated significant enhancements in activation levels within the dorsolateral prefrontal cortex (DLPFC) and primary motor cortex (PMC) following stimulation. Moreover, improved functional connectivity (FC) between related cortical areas was observed, suggesting that cerebellar stimulation promotes an integrated approach to rehabilitation by facilitating communication among brain regions essential for motor and cognitive recovery.

This approach not only enhances motor function but also contributes to cognitive improvements, demonstrating the cerebellum’s dual role in stroke rehabilitation. The ability of iTBS to induce rapid neuroplastic changes underscores its potential as a therapeutic intervention in acute and chronic stroke recovery settings.

Understanding Microglial Responses to Traumatic Brain Injury

Microglia are the resident immune cells of the central nervous system and play a pivotal role in the inflammatory response following a traumatic brain injury (TBI). Upon injury, microglia undergo rapid activation, a process that can either exacerbate neuronal damage or promote recovery through tissue remodeling and neurogenesis (Zhao et al., 2025).

The dynamics of microglial activation are complex and vary across different injury phases. Traditional classifications of microglial activation into M1 (pro-inflammatory) and M2 (anti-inflammatory) phenotypes are being challenged by emerging insights from single-cell transcriptomic analyses, which reveal a diverse array of microglial states. Understanding these distinct microglial populations and their temporal evolution is crucial for developing targeted therapeutic strategies aimed at modulating neuroinflammation and enhancing recovery after TBI.

Recent studies suggest that specific microglial subsets may serve as therapeutic targets for neuroimmune interventions, offering a promising avenue for mitigating the long-term effects of TBI. By integrating findings from clinical and preclinical studies, researchers aim to bridge the gap between mechanistic insights and therapeutic advancements in neuroinflammatory disorders.

Impact of Elongated Needle Therapy on Post-Stroke Recovery

Elongated needle therapy, a form of acupuncture, has emerged as a promising intervention for improving motor and balance functions in stroke patients. A systematic review and meta-analysis encompassing 18 randomized controlled trials involving 1,230 subjects indicated that this therapy significantly enhances balance and motor ability compared to conventional acupuncture and rehabilitation training (Zhang & Zhou, 2025).

The elongated needle, characterized by its long length and flexible design, is believed to penetrate deeper into tissue, providing more substantial stimulation of acupuncture points. This method not only initiates muscle contractions but also promotes muscle strength and coordination in affected limbs, which are critical for restoring functional independence in stroke survivors.

Table 1: Summary of Efficacy of Elongated Needle Therapy

The findings from this meta-analysis underscore the need for further high-quality, large-scale studies to validate the efficacy of elongated needle therapy as a standard intervention in stroke rehabilitation.

Function of Dlg4/PSD95 in Cognitive and Motor Learning

The Dlg4 gene, which encodes the postsynaptic density protein PSD-95, plays a critical role in synaptic plasticity and cognitive functions. In the context of Huntington’s disease, restoring Dlg4/PSD95 expression has been shown to ameliorate cognitive and motor learning deficits in mouse models (Fernández et al., 2025).

Studies indicate that a triple serine motif in the intracellular domain of SorCS2 is crucial for mediating neurotrophic signaling through BDNF pathways, which are essential for synaptic health and cognitive function. The restoration of Dlg4/PSD95 expression using artificial transcription factors has been identified as a potential therapeutic approach to enhance synaptic function and improve learning outcomes in neurodegenerative diseases.

Mechanisms of Nitric Oxide in Cerebellar Plasticity and Learning

Nitric oxide (NO) is a critical signaling molecule involved in various neurobiological processes, including synaptic plasticity and cerebellar learning paradigms. In the context of eye-blinking classical conditioning (EBCC), NO influences synaptic modifications at the purkinje cell level, facilitating learning and memory (Geminiani et al., 2025).

The production and diffusion of NO from specific neuronal sources play a key role in modulating synaptic activity and enhancing learning efficiency. By manipulating NO signaling pathways within cerebellar circuits, researchers can potentially improve adaptive learning processes and motor coordination in stroke patients.

Frequently Asked Questions (FAQ)

What is stroke rehabilitation?

Stroke rehabilitation refers to the process of recovering lost skills and abilities after a stroke. This may involve physical therapy, occupational therapy, speech therapy, and other interventions tailored to the individual’s needs.

How does cerebellar stimulation aid recovery?

Cerebellar stimulation enhances motor control and cognitive functions by promoting neural plasticity in affected brain regions. Techniques such as iTBS have shown promise in improving outcomes for stroke patients.

What role do microglia play in brain recovery?

Microglia are immune cells in the brain that respond to injury by modulating inflammation and facilitating tissue repair. Their activation can either promote recovery or exacerbate damage, making them critical targets for therapeutic interventions after traumatic brain injury.

What is elongated needle therapy?

Elongated needle therapy is a form of acupuncture that uses longer needles to penetrate deeper into tissues, providing enhanced stimulation of acupuncture points. It has been shown to improve motor and balance functions in stroke patients.

How does Dlg4/PSD95 relate to cognitive function?

Dlg4/PSD95 is a key protein involved in synaptic plasticity, which is essential for learning and memory. Restoring its expression has been shown to improve cognitive and motor learning deficits in animal models of neurodegenerative diseases.

References

1. Xu, S., Chen, S., Liang, C., Huang, H., Zou, H., Jiang, H. (2025). Immediate Neuroplastic Changes in the Cortex After iTBS on the Cerebellum of Stroke Patients: A Preliminary fNIRS Study

2. Zhao, J.-Y., Zhou, Y., Zhou, C.-W., Zhan, K.-B., Yang, M., Wen, M., Zhu, L.-Q. (2025). Revisiting the critical roles of reactive microglia in traumatic brain injury

3. Zhang, S., Zhou, H. (2025). Efficacy of elongated needles for motor and balance function after a stroke: a systematic review and meta-analysis. Frontiers in Neurology. https://doi.org/10.3389/fneur.2025.1550611

4. Fernández, G., Leiva, K., Bustos, F. J., van Zundert, B. (2025). Restoring endogenous Dlg4/PSD95 expression by an artificial transcription factor ameliorates cognitive and motor learning deficits in the R6/2 mouse model of Huntington’s disease. Clinical Epigenetics. https://doi.org/10.1186/s13148-025-01903-2

5. Geminiani, A., et al. (2025). Modeling nitric oxide diffusion and plasticity modulation in cerebellar learning. iScience. https://doi.org/10.1016/j.isci.2025.112695