Effective cerebellar neuroprosthetic control after stroke

Brain-machine interfaces (BMIs) offer a viable option for restoring function in patients with motor disabilities post-stroke. Most BMI systems rely on signals from the motor cortex (M1), which is often compromised after stroke. The cerebellum, a subcortical structure involved in motor control, remains an underexplored source for neuroprosthetic control. Using chronic electrophysiological recordings in a rat stroke model, we show that cerebellar neural activity can effectively drive BMI control, performing comparably to M1-driven control. We observed this even in animals with motor impairments post-stroke. Simultaneous M1-cerebellum recordings during cerebellar BMI control revealed that cerebellar "direct" neurons driving the interface were influenced by both local cerebellar and distant M1 neurons. While cerebellar influence remained stable, M1's interaction with cerebellar direct neurons shifted from longer to shorter timescales after stroke. These findings highlight that cerebellar direct neural control is possible in the stroke brain and reveal changes in M1-cerebellar network dynamics post-stroke.