Author:
Astrakas Loukas G.,Li Shasha,Ottensmeyer Mark P.,Pusatere Christian,Moskowitz Michael A.,Tzika A. Aria
Abstract
Background:
Ischemic stroke is the most common cause of complex chronic disability and the third leading cause of death worldwide. In recovering stroke patients, peak activation within the ipsilesional primary motor cortex (M1) during the performance of a simple motor task has been shown to exhibit an anterior shift in many studies and a posterior shift in other studies.
Objective:
We investigated this discrepancy in chronic stroke patients who completed a robot-assisted rehabilitation therapy program.
Methods:
Eight chronic stroke patients with an intact M1 and 13 Healthy Control (HC) volunteers underwent 300 functional magnetic resonance imaging (fMRI) scans while performing a grip task at different force levels with a robotic device. The patients were trained with the same robotic device over a 10-week intervention period and their progress was evaluated serially with the Fugl-Meyer and Modified Ashworth scales. Repeated measure analyses were used to assess group differences in locations of peak activity in the sensorimotor cortex (SM) and the relationship of such changes with scores on the Fugl-Meyer Upper Extremity (FM UE) scale.
Results:
Patients moving their stroke-affected hand had proportionally more peak activations in the primary motor area and fewer peak activations in the somatosensory cortex than the healthy controls (P=0.009). They also showed an anterior shift of peak activity on average of 5.3-mm (P<0.001). The shift correlated negatively with FM UE scores (P=0.002).
Conclusion:
A stroke rehabilitation grip task with a robotic device was confirmed to be feasible during fMRI scanning and thus amenable to be used to assess plastic changes in neurological motor activity. Location of peak activity in the SM is a promising clinical neuroimaging index for the evaluation and monitoring of chronic stroke patients.
Publisher
Bentham Science Publishers Ltd.
Subject
Clinical Neurology,Radiology Nuclear Medicine and imaging
Reference49 articles.
1. Barquera S, Pedroza-Tobías A, Medina C, et al.
Global overview of the epidemiology of atherosclerotic cardiovascular disease.
Arch Med Res
2015;
46
(5)
: 328-38.
2. Kwakkel G, Kollen B, Lindeman E.
Understanding the pattern of functional recovery after stroke: facts and theories.
Restor Neurol Neurosci
2004;
22
(3-5)
: 281-99.
3. Ballester BR, Maier M, Duff A, et al.
A critical time window for recovery extends beyond one-year post-stroke.
J Neurophysiol
2019;
122
(1)
: 350-7.
4. Fasoli SE, Krebs HI, Hogan N.
Robotic technology and stroke rehabilitation: translating research into practice.
Top Stroke Rehabil
2004;
11
(4)
: 11-9.
5. Chang WH, Kim YH.
Robot-assisted therapy in stroke rehabilitation.
J Stroke
2013;
15
(3)
: 174-81.
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