BrainMap: Ron D. Frostig, PhD

Collateral circulation based protection from impending ischemic stroke

The majority of cortical ischemic strokes in humans originate from blockage in the middle cerebral artery (MCA). There is only one FDA-approved drug (rtPA) available for helping ischemic stroke victims, but it has limited efficacy. Therefore, in recent years there has been an active search for alternative protection strategies. Applying an array of techniques (high-resolution functional imaging, blood flow imaging, neuronal recordings, and histology) and complemented by a battery of behavioral tests, our lab has demonstrated in rat model of permanent MCA occlusion (pMCAo) that protection can be achieved by delivery of tactile stimulation during a 2h window following pMCAo. Such protection critically depends on patent pial (aka leptomeningeal) collaterals, as sensory stimulation enhances retrograde blood flow into the occluded MCA through the collateral system resulting in protective reperfusion. Results of applying sensory-based treatment in various rodent models will be described. Our findings add support to a collateral circulation based protective stroke treatment in animal models and humans known as ‘collateral therapeutics’.