连接点:中风后运动学习障碍中的运动和默认模式网络交叉点

IF 3.4 2区 医学 Q2 NEUROIMAGING
Christiane Dahms , Alexander Noll , Franziska Wagner , Alexander Schmidt , Stefan Brodoehl , Carsten M. Klingner
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引用次数: 0

摘要

背景脑卒中经常导致长期的运动障碍,给个人和经济带来沉重负担。然而,我们对支配中风幸存者运动学习的潜在神经机制的了解仍然有限,这给治疗策略的开发和优化带来了巨大挑战。我们假设中风患者的整体运动学习能力会受到损害,这与大脑中运动模式和默认模式网络的活动和连接模式的改变有关。方法我们使用功能磁共振成像(fMRI)和连接分析评估了 40 名慢性期轻度受损的中风幸存者和 39 名年龄匹配的健康对照组。我们重点研究了用未受损或非优势手完成单侧运动序列学习任务时的神经活动和连接模式。结果与对照组相比,中风患者的运动学习能力明显下降,这与大脑侧化减弱有关。任务诱导的活动调制在运动网络中减少,但在默认模式网络中增加。结论脑卒中患者在用未受影响的手进行运动学习时,其神经活动和连接模式发生了改变,这可能是导致其运动学习能力全面受损的原因之一。这些患者的大脑激活侧化能力降低,同时左右运动皮层之间的连通性增强,这可能意味着不适应的神经过程阻碍了运动适应,从而可能影响中风后的长期康复。默认模式网络的活动调制和连接改变的对比模式表明,该网络在中风后的运动学习中发挥着微妙的作用。这些见解可能对为中风患者量身定制康复策略具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Connecting the dots: Motor and default mode network crossroads in post-stroke motor learning deficits

Connecting the dots: Motor and default mode network crossroads in post-stroke motor learning deficits

Background

Strokes frequently result in long-term motor deficits, imposing significant personal and economic burdens. However, our understanding of the underlying neural mechanisms governing motor learning in stroke survivors remains limited - a fact that poses significant challenges to the development and optimisation of therapeutic strategies.

Objective

This study investigates the diversity in motor learning aptitude and its associated neurological mechanisms. We hypothesised that stroke patients exhibit compromised overall motor learning capacity, which is associated with altered activity and connectivity patterns in the motor- and default-mode-network in the brain.

Methods

We assessed a cohort of 40 chronic-stage, mildly impaired stroke survivors and 39 age-matched healthy controls using functional Magnetic Resonance Imaging (fMRI) and connectivity analyses. We focused on neural activity and connectivity patterns during an unilateral motor sequence learning task performed with the unimpaired or non-dominant hand. Primary outcome measures included task-induced changes in neural activity and network connectivity.

Results

Compared to controls, stroke patients showed significantly reduced motor learning capacity, associated with diminished cerebral lateralization. Task induced activity modulation was reduced in the motor network but increased in the default mode network. The modulated activation strength was associated with an opposing trend in task-induced functional connectivity, with increased connectivity in the motor network and decreased connectivity in the DMN.

Conclusions

Stroke patients demonstrate altered neural activity and connectivity patterns during motor learning with their unaffected hand, potentially contributing to globally impaired motor learning skills. The reduced ability to lateralize cerebral activation, along with the enhanced connectivity between the right and left motor cortices in these patients, may signify maladaptive neural processes that impede motor adaptation, possibly affecting long-term rehabilitation post-stroke. The contrasting pattern of activity modulation and connectivity alteration in the default mode network suggests a nuanced role of this network in post-stroke motor learning. These insights could have significant implications for the development of customised rehabilitation strategies for stroke patients.

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来源期刊
Neuroimage-Clinical
Neuroimage-Clinical NEUROIMAGING-
CiteScore
7.50
自引率
4.80%
发文量
368
审稿时长
52 days
期刊介绍: NeuroImage: Clinical, a journal of diseases, disorders and syndromes involving the Nervous System, provides a vehicle for communicating important advances in the study of abnormal structure-function relationships of the human nervous system based on imaging. The focus of NeuroImage: Clinical is on defining changes to the brain associated with primary neurologic and psychiatric diseases and disorders of the nervous system as well as behavioral syndromes and developmental conditions. The main criterion for judging papers is the extent of scientific advancement in the understanding of the pathophysiologic mechanisms of diseases and disorders, in identification of functional models that link clinical signs and symptoms with brain function and in the creation of image based tools applicable to a broad range of clinical needs including diagnosis, monitoring and tracking of illness, predicting therapeutic response and development of new treatments. Papers dealing with structure and function in animal models will also be considered if they reveal mechanisms that can be readily translated to human conditions.
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