Intracerebral Cell Therapy and the Impact of Physical Therapy

Recently published in the Journal of Cerebral Blood and Metabolism, the article entitled “Physical therapy exerts sub-additive and suppressive effects on intracerebral neural stem cell implantation in a rat model of stroke” investigates how physical therapy affects neural stem cells implanted into stroke damage. McGowan Institute for Regenerative Medicine affiliated faculty members and collaborative authors on this work are Michel Modo, PhD, Professor in the Department of Radiology at the University of Pittsburgh, and Fabrisia Ambrosio, PhD, MPT, Director of Rehabilitation for UPMC International and an Associate Professor in the Department of Physical Medicine & Rehabilitation at the University of Pittsburgh.

This study used the neural stem cells undergoing clinical trials for stroke by ReNeuron (PISCES trials). A key question in these trials was whether patients should get physical therapy or not as it was unclear if this was required for these cells to form Hebbian synapses or if both might act on the same target. Researchers found both sub-additive and suppressive effects here which potentially can have significant implications for the design of future clinical trials.

The abstract from this article follows:

Intracerebral cell therapy (CT) is emerging as a new therapeutic paradigm for stroke. However, the impact of physical therapy (PT) on implanted cells and their ability to promote recovery remains poorly understood. To address this translational issue, a clinical-grade neural stem cell (NSC) line was implanted into peri-infarct tissue using MRI-defined injection sites, two weeks after stroke. PT in the form of aerobic exercise (AE) was administered 5 × per week post-implantation using a paradigm commonly applied in patients with stroke. A combined AE and CT exerted sub-additive therapeutic effects on sensory neglect, whereas AE suppressed CT effects on motor integration and grip strength. Behavioral testing emerged as a potentially major component for task integration. It is expected that this study will guide and inform the incorporation of PT in the design of clinical trials evaluating intraparenchymal NSCs implantation for stroke.

This study was funded in part by the Alliance for Regenerative Rehabilitation Research and Training (AR3T).