Cortical reorganization after motor stroke: A pilot study on differences between the upper and lower limbs.
Aged
Aged, 80 and over
Chronic Disease
Connectome
Female
Foot
/ physiopathology
Hand
/ physiopathology
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Motor Activity
/ physiology
Motor Cortex
/ diagnostic imaging
Nerve Net
/ diagnostic imaging
Paresis
/ diagnostic imaging
Pilot Projects
Recovery of Function
/ physiology
Stroke
/ complications
dynamic causal modeling
effective connectivity
fMRI
interhemispheric inhibition
motor recovery
plasticity
rehabilitation
Journal
Human brain mapping
ISSN: 1097-0193
Titre abrégé: Hum Brain Mapp
Pays: United States
ID NLM: 9419065
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
05
05
2020
revised:
03
09
2020
accepted:
29
09
2020
pubmed:
10
11
2020
medline:
4
1
2022
entrez:
9
11
2020
Statut:
ppublish
Résumé
Stroke patients suffering from hemiparesis may show substantial recovery in the first months poststroke due to neural reorganization. While reorganization driving improvement of upper hand motor function has been frequently investigated, much less is known about the changes underlying recovery of lower limb function. We, therefore, investigated neural network dynamics giving rise to movements of both the hands and feet in 12 well-recovered left-hemispheric chronic stroke patients and 12 healthy participants using a functional magnetic resonance imaging sparse sampling design and dynamic causal modeling (DCM). We found that the level of neural activity underlying movements of the affected right hand and foot positively correlated with residual motor impairment, in both ipsilesional and contralesional premotor as well as left primary motor (M1) regions. Furthermore, M1 representations of the affected limb showed significantly stronger increase in BOLD activity compared to healthy controls and compared to the respective other limb. DCM revealed reduced endogenous connectivity of M1 of both limbs in patients compared to controls. However, when testing for the specific effect of movement on interregional connectivity, interhemispheric inhibition of the contralesional M1 during movements of the affected hand was not detected in patients whereas no differences in condition-dependent connectivity were found for foot movements compared to controls. In contrast, both groups featured positive interhemispheric M1 coupling, that is, facilitation of neural activity, mediating movements of the affected foot. These exploratory findings help to explain why functional recovery of the upper and lower limbs often develops differently after stroke, supporting limb-specific rehabilitative strategies.
Identifiants
pubmed: 33165996
doi: 10.1002/hbm.25275
pmc: PMC7856649
doi:
Types de publication
Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1013-1033Subventions
Organisme : NIMH NIH HHS
ID : R01 MH074457
Pays : United States
Organisme : NIMH NIH HHS
ID : R56 MH074457
Pays : United States
Informations de copyright
© 2020 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.
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