Background.
Reorganization in motor areas have been suggested after motor imagery
training (MIT). However, motor imagery involves a large-scale brain
network, in which many regions, and not only the motor areas, potentially
constitute the neural substrate for MIT.
Objective.
This study
aimed to identify the targets for MIT in stroke rehabilitation from a
voxel-based whole brain analysis of resting-state functional magnetic
resonance imaging (fMRI).
Methods.
Thirty-four chronic stroke
patients were recruited and randomly assigned to either an MIT group or a
control group. The MIT group received a 4-week treatment of MIT plus
conventional rehabilitation therapy (CRT), whereas the control group
only received CRT. Before and after intervention, the Fugl-Meyer
Assessment Upper Limb subscale (FM-UL) and resting-state fMRI were
collected. The fractional amplitude of low-frequency fluctuations
(fALFF) in the slow-5 band (0.01-0.027 Hz) was calculated across the
whole brain to identify brain areas with distinct changes between 2
groups. These brain areas were then targeted as seeds to perform
seed-based functional connectivity (FC) analysis.
Results.
In
comparison with the control group, the MIT group exhibited more
improvements in FM-UL and increased slow-5 fALFF in the ipsilesional
inferior parietal lobule (IPL). The change of the slow-5 oscillations in
the ipsilesional IPL was positively correlated with the improvement of
FM-UL. The MIT group also showed distinct alternations in FCs of the
ipsilesional IPL, which were correlated with the improvement of FM-UL.
Conclusions.
The rehabilitation efficiency of MIT was associated with increased
slow-5 oscillations and altered FC in the ipsilesional IPL.
Clinical Trial Registration.
http://www.chictr.org.cn.
Unique Identifier. ChiCTR-TRC-08003005.
No comments:
Post a Comment