To select the functional tests for our SPAN project, we think about what deficits the stroke animals still have at four weeks. Our goal is to detect whether the deficits are improved by the drugs we are testing or not. So sometimes, that can not be done with a simple test. 

The 48-point score and Garcia's score (bold) are listed below.  By four weeks post-stroke, we may not see the deficits in spontaneous activity, body symmetry, gait, climbing, hind leg placement, and hind leg touch.  So the vehicle animals may have a 13-14 Garcia score (a 4-5 deficit score) and a 15-16 48-point score (a 15-16 deficit score).  A small scale may be less sensitive to picking up the difference when the efficacy is not so potent.  It is excellent to use AI in assisting our data analysis. However, catching the information we need using AI is not easy.  Should we think about how to modify and fit what we need?

NIH Stroke Scale-like Neurological Score System (14 categories, 0 = normal and 48 = severe) vs. Garcia’s score (6 categories, 3=severe and 18=normal)  

General Status (0-12)

The animal is placed in a new cage with bedding and watched for 5 minutes.

1. Spontaneous activity (0-4)

0 point: Brisk, can stand up by holding walls

1 point: Walks but can’t stand up by holding walls

2 points: Can walk, but trends to rest

3 points: Can’t walk, can look around

4 points: No movement

1. Spontaneous Activity (3-0).   The animal was observed for 5 minutes in its normal environment (cage). The rat's activity was assessed by its ability to approach all four walls of the cage. Scores indicate the following: 3, rat moved around, explored the environment, and approached at least three walls of the cage; 2, slightly affected rat moved about in the cage but did not approach all sides and hesitated to move, although it eventually reached at least one upper rim of the cage; 1, severely affected rat did not rise up at all and barely moved in the cage; and 0, rat did not move at all.

2. Body symmetry (0-4)

0 point: Posture shift to both sides

1 point: Head to one side, rarely head to the other side

2 points: Posture shifts to one side continuously

3 points: Posture shifts to one side, but hardly walks

4 points: does not walk

2. Symmetry in the Movement of Four Limbs (3-0).   The rat was held in the air by the tail to observe symmetry in the movement of the four limbs. Scores indicate the following: 3, all four limbs extended symmetrically; 2, limbs on left side extended less or more slowly than those on the right; 1, limbs on left side showed minimal movement; and 0, forelimb on left side did not move at all.

Note: Animals are held in the air (not comfortable). We changed to watch it inside the cage.

The animal is placed on the table surface and watched.

3. Gait (0-4)

0 point: Walk freely, no abnormality

1 point: Supports left extremities by right

2 points: Clear limping or body swinging

3 points: Difficult walking

4 points: Does not walk

Motor Functions (0-22)

The animal is on the table. The tail is held up, and the front legs are allowed to touch the table surface.

4. Front limb symmetry (0-4)

0 point: Stretches both arms symmetrically

1 point: Asymmetry, difference less than 45 degrees

2 points: Asymmetry, difference more than 45 degrees

3 points: Asymmetry, can’t extend left arm

4 points: No movement in left arm

3. Forepaw Outstretching (3-0).   The rat was brought up to the edge of the table and made to walk on forelimbs while being held by the tail. Symmetry in the outstretching of both forelimbs was observed while the rat reached the table and the hindlimbs were kept in the air. Scores indicate the following: 3, both forelimbs were outstretched, and the rat walked symmetrically on forepaws; 2, left side outstretched less than the right, and forepaw walking was impaired; 1, left forelimb moved minimally; and 0, left forelimb did not move.

The animal is placed on the table and allowed to walk freely.

5. Circling / bench top (0-4)

0 point: Turns to both sides equally

1 point: Tendency to turn to one side, can walk straight

2 points: Circles to one side, makes a large circle, can’t walk straight

3 points: Circles constantly to one side, make a small circle

4 points: Circles to one side without walking or no movement

The animal is on the table. The tail is held up, and only the front limbs are allowed to walk on the table surface.

6. Circling / holding tail (0-4)

0 point: Walks in both directions

1 point: Tendency to circle to one side, occasionally turns to the other side

2 points: Circles to one side

3 points: Circles to one side sluggishly

4 points: Does not advance, no movement

The animal is on the table. The hind limbs are left outside the table.

7. Hind limb placement (0-2)

0 point: Immediately place on the table

1 point: Slowly place on the table

2 points: fail to place on the table

The animal is placed on the screen, which is then turned almost vertically.

8. Screen climb (0-4)

0 point: Completes climbing, shifts to both sides

1 point: Climbs and shifts to one side

2 points: Holds on slope but does not climb

3 points: Slides down slope with some effort

4 points: Slides immediately, no effort to prevent fall

4. Climbing (3-1). The rat was placed on the wall of a wire cage. Normally the rat uses all four limbs to climb up the wall. When the rat was removed from the wire cage by pulling it off by the tail, the strength of attachment was noted. Scores indicate the following: 3, rat climbed easily and gripped tightly to the wire; 2, left side was impaired while climbing or did not grip as hard as the right side; and 1, rat failed to climb or tended to circle instead of climbing.

The animal is placed in the middle of the beam and allowed to walk.

9. Beam walking (0-4)

0 point: Reaches up to the end wall

1 point: Can walk on the beam but does not reach up to the end wall

2 points: Can’t walk on the beam but stays more than 10 seconds

3 points: Stays on the beam less than 1o seconds

4 points: Fall immediately without any effort to prevent fall

Sensory functions (0-14)

The animal is placed on the table and allowed to move freely. Use the needle to touch when the animal is not walking.

10. Front limb touch (0-2)

0 point: Brisk on both sides

1 point: Slow left and brisk right

2 points: Absent left and some responses right

11. Hind limb touch (0-2)

0 point: Brisk on both sides

1 point: Slow left and brisk right

2 points: Absent left and some responses right

Animal is placed inside the cage. Use the needle to touch the truck, vibrissae, and face.

12. Trunk touch (0-4)

0 point: Brisk bilaterally

1 point: Slow left and brisk right

2 points: Absent left and brisk right

3 points: Absent left and slow right

4 points: Absent bilaterally

 

5. Body Proprioception (3-1). The rat was touched with a blunt stick on each side of the body, and the reaction to the stimulus was observed. Scores indicate the following: 3, rat reacted by turning head and was equally startled by the stimulus on both sides; 2, rat reacted slowly to stimulus on left side; and 1, rat did not respond to the stimulus placed on the left side.

13. Vibrissae touch (0-4)

0 point: Brisk bilaterally

1 point: Slow left and brisk right

2 points: Absent left and brisk right

3 points: Absent left and slow right

4 points: Absent bilaterally

6. Response to Vibrissae Touch (3-1).  A blunt stick was brushed against the vibrissae on each side; the stick was moved toward the whiskers from the rear of the animal to avoid entering the visual fields. Scores indicate the following: 3, rat reacted by turning head or was equally startled by the stimulus on both sides; 2, rat reacted slowly to stimulus on left side; and 1, rat did not respond to stimulus on the left side.

14. Face touch (0-2)

0 point: Brisk on both sides

1 point: Slow left and brisk right

2 points: Absent left and some responses right