From March, 2012;
From may, 2012;
From Oct. 2012;
From Nov. 2012;
From Dec. 2012;
From Feb. 2013;
From May, 2013 in New Zealand;
From July, 2013 in Germany;
And the latest here;
- Soha Saleh, PhD1,2
- Sergei V. Adamovich, PhD1,2,3
- Eugene Tunik, PhD, PT1
- 1Department of Rehabilitation and Movement Science, Rutgers University, Newark, NJ, USA
- 2Graduate School of Biomedical Sciences, Rutgers University, Newark, NJ, USA
- 3Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
- Eugene Tunik, PhD, PT, Department of Rehabilitation and Movement Science, Rutgers University, 65 Bergen Street, 7th Floor, Newark, NJ 07101, USA. Email: eugene.tunik@rutgers.edu
Abstract
Background. Mirrored feedback has
potential as a therapeutic intervention to restore hand function after
stroke. However, the functional
(effective) connectivity of neural networks
involved in processing mirrored feedback after stroke is not known. Objective. To determine if regions recruited by mirrored feedback topographically overlap with those involved in control of the paretic
hand and to identify the effective connectivity of activated nodes within the mirrored feedback network. Methods.
Fifteen patients with chronic stroke performed a finger flexion task
with their unaffected hand during event-related functional
magnetic resonance imaging (fMRI). Real-time hand
kinematics was recorded during fMRI and used to actuate hand models
presented
in virtual reality (VR). Visual feedback of the
unaffected hand motion was manipulated pseudorandomly by either
actuating
the VR hand corresponding to the moving unaffected
side (veridical feedback) or the affected side (mirrored feedback). In
2 control conditions, the VR hands were replaced
with moving nonanthropomorphic shapes. Results. Mirrored
feedback was associated with significant activation of regions within
and outside the ipsilesional sensorimotor
cortex, overlapping with areas engaged when
patients performed the task with their affected hand. Effective
connectivity analysis
showed a significantly interconnected ipsilesional
somatosensory and motor cortex in the mirrored feedback condition. Conclusions.
Mirrored feedback recruits ipsilesional brain areas relevant for
control of the affected hand. These data provide a neurophysiological
basis by which mirrored feedback may be beneficial
as a therapy for restoring function after stroke.
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