Correlation between motor improvements and altered fMRI activity after rehabilitative therapy
Correlation between motor improvements and altered fMRI activity after rehabilitative therapy
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DOI：
10.1093/brain/awf282
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发表时间：
2002-12-01
期刊：
影响因子：
14.5
通讯作者：
Matthews, PM
中科院分区：
文献类型：
--
作者：
Johansen-Berg, H;Dawes, H;Matthews, PM
运动康复治疗通常在中风后使用，但结果是可变的，并且关于与改善功能相关的大脑活动变化的具体信息很少。我们对中风后接受某种形式康复治疗的七名患者进行了系列功能性MRI（fMRI），以描述与行为改善相关的大脑功能变化。患者进行扫描，同时进行两次手部屈伸运动之前和两次后，两个星期的家庭为基础的治疗方案相结合的约束未受影响的肢体与渐进式练习患肢。正如预期的那样，治疗后手功能的改善程度因患者而异。手功能的治疗相关改善与受累手对侧运动前皮质和次级体感皮质以及双侧小脑半球上级后部区域（脚I和小叶VI）的fMRI活动增加相关。功能磁共振成像提供了一个有前途的，客观的方法，专门确定脑活动的变化可能负责康复介导的功能恢复后中风。我们的研究结果表明，感觉运动区域的活动变化与成功的运动康复有关。
Motor rehabilitation therapy is commonly employed after strokes, but outcomes are variable and there is little specific information about the changes in brain activity that are associated with improved function. We performed serial functional MRI (fMRI) on a group of seven patients receiving a form of rehabilitation therapy after stroke in order to characterize functional changes in the brain that correlate with behavioural improvements. Patients were scanned while performing a hand flexion-extension movement twice before and twice after a two-week home-based therapy programme combining restraint of the unaffected limb with progressive exercises for the affected limb. As expected, the extent of improvement in hand function after therapy varied between patients. Therapy-related improvements in hand function correlated with increases in fMRI activity in the premotor cortex and secondary somatosensory cortex contralateral to the affected hand, and in superior posterior regions of the cerebellar hemispheres bilaterally (Crus I and lobule VI). fMRI offers a promising, objective approach for specifically identifying changes in brain activity potentially responsible for rehabilitation-mediated recovery of function after stroke. Our results suggest that activity changes in sensorimotor regions are associated with successful motor rehabilitation.