Rehabilitative Success After Brain Trauma by Augmenting a Subtherapeutic Dose of Environmental Enrichment With Galantamine

Neurorehabil Neural Repair. 2017 Oct-Nov;31(10-11):977-985. doi: 10.1177/1545968317739999. Epub 2017 Nov 12.

Abstract

Background: Environmental enrichment (EE) confers benefits after traumatic brain injury (TBI) when provided daily for > 6 hours, but not 2 or 4 hours, which more accurately reflects the daily amount of clinical rehabilitation. The lack of benefit with sub-therapeutic EE suggests that augmentation with galantamine (GAL), which enhances cognition after TBI, may be indicated to confer benefits.

Objective: To test the hypothesis that 2 and 4 hours of EE paired with GAL will provide benefits comparable to 24 hours of EE alone. Moreover, all EE groups will perform better than the standard (STD)-housed GAL group.

Methods: Anesthetized rats received a TBI or sham injury and then were randomized to receive intraperitoneal injections of GAL (2 mg/kg) or saline vehicle (VEH; 1 mL/kg) beginning 24 hours after surgery and once daily while receiving EE for 2, 4, or 24 hours. Motor and cognitive assessments were conducted on postoperative days 1-5 and 14-19, respectively.

Results: Motor function was significantly improved in the TBI + 24-hour EE group versus the TBI + STD + VEH and TBI + STD + GAL groups ( P < .05). Cognitive performance was enhanced in all EE groups as well as in the TBI + STD + GAL versus TBI + STD + VEH ( P < .05). Moreover, the 2- and 4-hour EE groups receiving GAL did not differ from the 24-hour EE group ( P > .05) and performed better than GAL alone ( P < .05).

Conclusions: The findings support the hypothesis and have clinical relevance because, often, only brief rehabilitation may be available in the clinic and, thus, augmenting with a pharmacotherapy such as GAL may lead to outcomes that are significantly better than either therapy alone.

Keywords: Morris water maze; behavioral outcome; controlled cortical impact; environmental enrichment; functional recovery; galantamine; learning and memory; traumatic brain injury.

MeSH terms

  • Animals
  • Brain Injuries, Traumatic / complications
  • Brain Injuries, Traumatic / drug therapy*
  • Brain Injuries, Traumatic / rehabilitation*
  • Disease Models, Animal
  • Dose-Response Relationship, Drug
  • Environment*
  • Galantamine / therapeutic use*
  • Male
  • Memory Disorders / etiology
  • Neurologic Examination
  • Nootropic Agents / therapeutic use*
  • Postural Balance / drug effects
  • Psychomotor Performance / drug effects
  • Psychomotor Performance / physiology
  • Rats
  • Rats, Sprague-Dawley
  • Spatial Learning / drug effects
  • Time Factors
  • Treatment Outcome
  • Walking / physiology

Substances

  • Nootropic Agents
  • Galantamine