Peak Activation Shifts in the Sensorimotor Cortex of Chronic Stroke Patients Following Robot-assisted Rehabilitation Therapy.

Q4 Medicine
Open Neuroimaging Journal Pub Date : 2021-01-01 Epub Date: 2021-07-07 DOI:10.2174/1874440002114010008
Loukas G Astrakas, Shasha Li, Mark P Ottensmeyer, Christian Pusatere, Michael A Moskowitz, A Aria Tzika
{"title":"Peak Activation Shifts in the Sensorimotor Cortex of Chronic Stroke Patients Following Robot-assisted Rehabilitation Therapy.","authors":"Loukas G Astrakas,&nbsp;Shasha Li,&nbsp;Mark P Ottensmeyer,&nbsp;Christian Pusatere,&nbsp;Michael A Moskowitz,&nbsp;A Aria Tzika","doi":"10.2174/1874440002114010008","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>We investigated this discrepancy in chronic stroke patients who completed a robot-assisted rehabilitation therapy program.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":37431,"journal":{"name":"Open Neuroimaging Journal","volume":"14 ","pages":"8-15"},"PeriodicalIF":0.0000,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384467/pdf/","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Neuroimaging Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/1874440002114010008","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/7/7 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 2

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.

Abstract Image

Abstract Image

慢性脑卒中患者接受机器人辅助康复治疗后感觉运动皮层的峰值激活转移。
背景:缺血性脑卒中是复杂慢性残疾的最常见原因,也是全球第三大死亡原因。在恢复期中风患者中,在执行简单运动任务期间,同侧初级运动皮层(M1)的峰值激活在许多研究中显示为前移,在其他研究中显示为后移。目的:我们研究完成机器人辅助康复治疗项目的慢性脑卒中患者的这种差异。方法:8例慢性脑卒中患者和13例健康对照组(HC)志愿者在使用机器人装置执行不同握力水平的握力任务时进行300次功能性磁共振成像(fMRI)扫描。在10周的干预期内,患者使用相同的机器人设备进行训练,并使用Fugl-Meyer和Modified Ashworth量表对其进展进行连续评估。使用重复测量分析来评估感觉运动皮层(SM)峰值活动位置的组间差异,以及这种变化与Fugl-Meyer上肢(FM UE)量表得分的关系。结果:与健康对照组相比,运动中风手的患者初级运动区的峰值激活比例更高,体感觉皮层的峰值激活比例更低(P=0.009)。他们还显示出峰值活动平均前移5.3毫米(p结论:在fMRI扫描期间,机器人装置的中风康复握力任务被证实是可行的,因此可用于评估神经运动活动的可塑性变化。在慢性脑卒中患者的评估和监测中,SM峰活动定位是一个很有前景的临床神经影像学指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Open Neuroimaging Journal
Open Neuroimaging Journal Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
0.70
自引率
0.00%
发文量
3
期刊介绍: The Open Neuroimaging Journal is an Open Access online journal, which publishes research articles, reviews/mini-reviews, and letters in all important areas of brain function, structure and organization including neuroimaging, neuroradiology, analysis methods, functional MRI acquisition and physics, brain mapping, macroscopic level of brain organization, computational modeling and analysis, structure-function and brain-behavior relationships, anatomy and physiology, psychiatric diseases and disorders of the nervous system, use of imaging to the understanding of brain pathology and brain abnormalities, cognition and aging, social neuroscience, sensorimotor processing, communication and learning.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信