Recovery of post stroke proximal arm function, driven by complex neuroplastic bilateral brain activation patterns and predicted by baseline motor dysfunction severity
Objectives: Neuroplastic changes that drive recovery of shoulder/elbow function after stoke have been poorly understood. The purpose of this study was to determine the relationship between neuroplastic brain changes related to shoulder/elbow movement control in response to treatment and recovery of...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2015-07-01
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| Series: | Frontiers in Human Neuroscience |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fnhum.2015.00394/full |
| _version_ | 1818149316380852224 |
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| author | Svetlana ePundik Svetlana ePundik Jessica eMcCabe Ken eHrovat Alice E Fredrickson Curtis eTatsuoka I Jung eFeng Janis J Daly Janis J Daly |
| author_facet | Svetlana ePundik Svetlana ePundik Jessica eMcCabe Ken eHrovat Alice E Fredrickson Curtis eTatsuoka I Jung eFeng Janis J Daly Janis J Daly |
| author_sort | Svetlana ePundik |
| collection | DOAJ |
| description | Objectives: Neuroplastic changes that drive recovery of shoulder/elbow function after stoke have been poorly understood. The purpose of this study was to determine the relationship between neuroplastic brain changes related to shoulder/elbow movement control in response to treatment and recovery of arm motor function in chronic stroke survivors. Methods: Twenty-three chronic stroke survivors were treated with 12 weeks of arm rehabilitation. Outcome measures included functional Magnetic Resonance Imaging (fMRI) for the shoulder/elbow components of reach and a skilled motor function test (Arm Motor Abilities Test (AMAT)), collected before and after treatment.Results: We observed two patterns of neuroplastic changes that were associated with gains in motor function: decreased or increased task-related brain activation. Those with significantly better motor function at baseline exhibited a decrease in brain activation in response to treatment, evident in the ipsilesional primary motor and contralesional supplementary motor regions; in contrast, those with greater baseline motor impairment, exhibited increased brain activation in response to treatment. There was an linear relationship between greater functional gain (AMAT) and increased activation in bilateral primary motor, contralesional primary and secondary sensory regions, and contralesional lateral premotor area, after adjusting for baseline AMAT, age, and time since stroke. Conclusions: Recovery of functional reach involves recruitment of several contralesional and bilateral primary motor regions. In response to intensive therapy, the direction of functional brain change (i.e. increase or decrease in task-related brain recruitment) for shoulder/elbow reach components depends on baseline level of motor function and may represent either different phases or different strategies of neuroplasticity that drive functional recovery. |
| first_indexed | 2024-12-11T13:05:06Z |
| format | Article |
| id | doaj.art-1bcdc956d63c4a53b677f3ce1b90469d |
| institution | Directory Open Access Journal |
| issn | 1662-5161 |
| language | English |
| last_indexed | 2024-12-11T13:05:06Z |
| publishDate | 2015-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Human Neuroscience |
| spelling | doaj.art-1bcdc956d63c4a53b677f3ce1b90469d2022-12-22T01:06:21ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612015-07-01910.3389/fnhum.2015.00394135655Recovery of post stroke proximal arm function, driven by complex neuroplastic bilateral brain activation patterns and predicted by baseline motor dysfunction severitySvetlana ePundik0Svetlana ePundik1Jessica eMcCabe2Ken eHrovat3Alice E Fredrickson4Curtis eTatsuoka5I Jung eFeng6Janis J Daly7Janis J Daly8Cleveland Department of Veterans Affairs Medical CenterCase Western Reserve University School of MedicineCleveland Department of Veterans Affairs Medical CenterCleveland Department of Veterans Affairs Medical CenterCleveland Department of Veterans Affairs Medical CenterCase Western Reserve University School of MedicineCase Western Reserve UniveristyMR Gainesville Department of Veterans Affairs Medical CenterUniversity of Florida, College of MedicineObjectives: Neuroplastic changes that drive recovery of shoulder/elbow function after stoke have been poorly understood. The purpose of this study was to determine the relationship between neuroplastic brain changes related to shoulder/elbow movement control in response to treatment and recovery of arm motor function in chronic stroke survivors. Methods: Twenty-three chronic stroke survivors were treated with 12 weeks of arm rehabilitation. Outcome measures included functional Magnetic Resonance Imaging (fMRI) for the shoulder/elbow components of reach and a skilled motor function test (Arm Motor Abilities Test (AMAT)), collected before and after treatment.Results: We observed two patterns of neuroplastic changes that were associated with gains in motor function: decreased or increased task-related brain activation. Those with significantly better motor function at baseline exhibited a decrease in brain activation in response to treatment, evident in the ipsilesional primary motor and contralesional supplementary motor regions; in contrast, those with greater baseline motor impairment, exhibited increased brain activation in response to treatment. There was an linear relationship between greater functional gain (AMAT) and increased activation in bilateral primary motor, contralesional primary and secondary sensory regions, and contralesional lateral premotor area, after adjusting for baseline AMAT, age, and time since stroke. Conclusions: Recovery of functional reach involves recruitment of several contralesional and bilateral primary motor regions. In response to intensive therapy, the direction of functional brain change (i.e. increase or decrease in task-related brain recruitment) for shoulder/elbow reach components depends on baseline level of motor function and may represent either different phases or different strategies of neuroplasticity that drive functional recovery.http://journal.frontiersin.org/Journal/10.3389/fnhum.2015.00394/fullStrokefunctional magnetic resonance imagingneuroplasticitymotor learningmotor recoverymotor rehabilitation |
| spellingShingle | Svetlana ePundik Svetlana ePundik Jessica eMcCabe Ken eHrovat Alice E Fredrickson Curtis eTatsuoka I Jung eFeng Janis J Daly Janis J Daly Recovery of post stroke proximal arm function, driven by complex neuroplastic bilateral brain activation patterns and predicted by baseline motor dysfunction severity Frontiers in Human Neuroscience Stroke functional magnetic resonance imaging neuroplasticity motor learning motor recovery motor rehabilitation |
| title | Recovery of post stroke proximal arm function, driven by complex neuroplastic bilateral brain activation patterns and predicted by baseline motor dysfunction severity |
| title_full | Recovery of post stroke proximal arm function, driven by complex neuroplastic bilateral brain activation patterns and predicted by baseline motor dysfunction severity |
| title_fullStr | Recovery of post stroke proximal arm function, driven by complex neuroplastic bilateral brain activation patterns and predicted by baseline motor dysfunction severity |
| title_full_unstemmed | Recovery of post stroke proximal arm function, driven by complex neuroplastic bilateral brain activation patterns and predicted by baseline motor dysfunction severity |
| title_short | Recovery of post stroke proximal arm function, driven by complex neuroplastic bilateral brain activation patterns and predicted by baseline motor dysfunction severity |
| title_sort | recovery of post stroke proximal arm function driven by complex neuroplastic bilateral brain activation patterns and predicted by baseline motor dysfunction severity |
| topic | Stroke functional magnetic resonance imaging neuroplasticity motor learning motor recovery motor rehabilitation |
| url | http://journal.frontiersin.org/Journal/10.3389/fnhum.2015.00394/full |
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