The Neural Correlates of Long-Term Carryover following Functional Electrical Stimulation for Stroke.
The Neural Correlates of Long-Term Carryover following Functional Electrical Stimulation for Stroke.
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DOI：
10.1155/2016/4192718
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发表时间：
2016
影响因子：
3.1
通讯作者：
Pedrocchi A
中科院分区：
文献类型：
--
作者：
Gandolla M;Ward NS;Molteni F;Guanziroli E;Ferrigno G;Pedrocchi A
神经康复治疗中风的有效传递可能会通过建立一个机制的理解，如何提高适应性可塑性。功能性电刺激可有效减少卒中后足下垂;在某些患者中，治疗结束后效果仍然存在，其机制未知。我们使用功能性磁共振成像检查神经相关的功能性电刺激的关键元素，意志意图移动和并发刺激，在一组慢性中风患者接受功能性电刺激足下垂校正。患者表现出复杂网络中的任务相关激活，与年龄匹配的对照组共享双侧感觉运动和补充运动激活。我们观察到一致的分离的患者和无遗留影响的基础上，大脑的反应。经历了遗留效应的患者在补充运动区的反应，对应于健康对照组，实验因素之间的相互作用，在对侧角回只出现在那些没有遗留。我们认为，功能性电刺激遗留的作用机制是基于运动预测和代理/身体所有权的感觉，病人的能力，计划的运动和感知的刺激作为他/她自己的控制回路的一部分是很重要的遗留效应发生。
Neurorehabilitation effective delivery for stroke is likely to be improved by establishing a mechanistic understanding of how to enhance adaptive plasticity. Functional electrical stimulation is effective at reducing poststroke foot drop; in some patients, the effect persists after therapy has finished with an unknown mechanism. We used fMRI to examine neural correlates of functional electrical stimulation key elements, volitional intent to move and concurrent stimulation, in a group of chronic stroke patients receiving functional electrical stimulation for foot-drop correction. Patients exhibited task-related activation in a complex network, sharing bilateral sensorimotor and supplementary motor activation with age-matched controls. We observed consistent separation of patients with and without carryover effect on the basis of brain responses. Patients who experienced the carryover effect had responses in supplementary motor area that correspond to healthy controls; the interaction between experimental factors in contralateral angular gyrus was seen only in those without carryover. We suggest that the functional electrical stimulation carryover mechanism of action is based on movement prediction and sense of agency/body ownership—the ability of a patient to plan the movement and to perceive the stimulation as a part of his/her own control loop is important for carryover effect to take place.