Impact of transcranial direct current stimulation (tDCS) on cerebral vasospasm after subarachnoid hemorrhage (SAH) in an experimental rat model.

• Applicant: Professorin Dr. Dorothee Mielke
• Subject Area: Clinical Neurology; Neurosurgery and Neuroradiology
• Term: from 2014 to 2018
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 258153529

An acute, non-traumatic subarachnoid hemorrhage (SAH) is in eight out of ten cases the result of a ruptured intracranial aneurysm. The incidence is 6-8 cases per 100 000 residents per year. The overall annual risk of bleeding is approximately 1% / year, depending on accompanying risk factors and the aneurysm size. Despite an optimization of diagnostic and treatment strategies, the mortality and severe morbidity after an aneurysm rupture is still unacceptably high. In the first two weeks after the bleeding, the major cause of death and severe morbidity is the cerebral vasospasm, leading to ischemic infarctions, which are the major cause for delayed ischemic neurological deficits (DIND). Cerebral vasospasms are predominantly the result of released blood products and an inflammatory reaction in the subarachnoid space. Up to date, vasospasm is treated pharmacologically and interventionally with limited success. Aim of our project is to evaluate the effects of transcranial direct current stimulation (tDCS) on cerebral vasospasm after aneurysmal SAH. Current results of our research group proved that tDCS modulates cerebral blood flow in a polarity-specific way, in which the extent of modulation depends on the stimulation parameters applied. Hence, it appears feasible, that tDCS might have a positive effect on vasospasm and its sequel. Therefore, it is our aim to evaluate the effects of tDCS on cerebral vasospasm, respectively its influence on vasospasm-associated ischemia. Furthermore, if we are able to detect an influence of tDCS on cerebral vasospasm, the establishment of stimulation parameters with maximal response will be the next step. Herefrom, the proof of efficacy of tDCS on vasospasm and / or vasospasm-related ischemia would be of substantial clinical importance, because it would open a new noninvasive avenue in the treatment of patients with clinically relevant vasospasm after aneurysmal SAH.

• DFG Programme: Research Grants