Neural Mechanisms of Prism Adaptation in Healthy Adults and Individuals with Spatial Neglect after Unilateral Stroke: A Review of fMRI Studies.
Neural Mechanisms of Prism Adaptation in Healthy Adults and Individuals with Spatial Neglect after Unilateral Stroke: A Review of fMRI Studies.
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DOI：
10.3390/brainsci11111468
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发表时间：
2021-11-05
期刊：
影响因子：
3.3
通讯作者：
Chen P
中科院分区：
文献类型：
--
作者：
Boukrina O;Chen P
空间忽视导致的功能障碍阻碍了高达30%的中风幸存者的康复。棱镜适应治疗（PAT）可能会减轻空间忽视的致残后果，但我们还不知道为什么有些人在PAT后表现出比其他人更好的结果。本范围审查和荟萃分析的目的是调查棱镜适应（PA）的神经机制。我们对健康个体和因中风导致右脑或左脑损伤（RBD或LBD）的患者在PA之前、期间和之后的脑活动进行了fMRI研究的定量和定性分析。在健康成年人中，PA与后顶叶和小脑簇的活动有关，减少了双侧顶叶-额叶连接，增加了额叶边缘系统和感觉运动网络连接。相比之下，患有空间忽视的RBD个体依赖于不同的回路，包括完整的左枕叶皮层中的活动簇。这一发现与空间处理中半球优势向左半球的转移是一致的。然而，需要更多的研究来阐明单侧脑损伤后病变位置和负荷对PA所涉及的回路的贡献。未来的研究还需要阐明静息状态功能连接（rsFC）下降与视觉功能的关系。
Functional disability due to spatial neglect hinders recovery in up to 30% of stroke survivors. Prism adaptation treatment (PAT) may alleviate the disabling consequences of spatial neglect, but we do not yet know why some individuals show much better outcomes following PAT than others. The goal of this scoping review and meta-analysis was to investigate the neural mechanisms underlying prism adaptation (PA). We conducted both quantitative and qualitative analyses across fMRI studies investigating brain activity before, during, and after PA, in healthy individuals and patients with right or left brain damage (RBD or LBD) due to stroke. In healthy adults, PA was linked with activity in posterior parietal and cerebellar clusters, reduced bilateral parieto-frontal connectivity, and increased fronto-limbic and sensorimotor network connectivity. In contrast, RBD individuals with spatial neglect relied on different circuits, including an activity cluster in the intact left occipital cortex. This finding is consistent with a shift in hemispheric dominance in spatial processing to the left hemisphere. However, more studies are needed to clarify the contribution of lesion location and load on the circuits involved in PA after unilateral brain damage. Future studies are also needed to clarify the relationship of decreasing resting state functional connectivity (rsFC) to visuomotor function.
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