http://nnr.sagepub.com/content/28/9/874?etoc
- Iris C. Brunner, PhD1
- Jan Sture Skouen, MD, PhD1
- Lars Ersland, PhD2
- Renate Grüner, PhD1,2
- Iris C. Brunner, Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, Post Box 7804, 5020 Bergen, Norway. Email: iris.brunner@igs.uib.no
Abstract
Background. Action observation has been
suggested as a possible gateway to retraining arm motor function post
stroke. However, it is
unclear if the neuronal response to action
observation is affected by stroke and if it changes during the course of
recovery.
Objective. To examine longitudinal changes in neuronal activity in a group of patients with subacute stroke when observing and executing
a bimanual movement task.
Methods.
Eighteen patients were examined twice using 3-T functional magnetic
resonance imaging; 1 to 2 weeks and 3 months post stroke
symptom onset. Eighteen control participants were
examined once. Image time series were analyzed (SPM8) and correlated
with
clinical motor function scores.
Results. During action observation and execution, an overlap of neuronal activation was observed in the superior and inferior parietal
lobe, precentral gyrus, insula, and inferior temporal gyrus in both control participants and patients (P
< .05; false discovery rate corrected). The neuronal response in the
observation task increased from 1 to 2 weeks to 3 months
after stroke. Most activated clusters were observed
in the inferior temporal gyrus, the thalamus and movement-related
areas,
such as the premotor, supplementary and motor
cortex (BA4, BA6). Increased activation of cerebellum and premotor area
correlated
with improved arm motor function. Most patients had
regained full movement ability.
Conclusions. Plastic changes
in neurons responding to action observation and action execution
occurred in accordance with clinical recovery.
The involvement of motor areas when observing
actions early and later after stroke may constitute a possible access to
the
motor system.
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