Brain adaptation associated with spontaneous and training-induced recovery of touch sensation post-stroke.

大脑网络可能重组以优化中风恢复。然而，人们对中风后自然恢复和训练诱导恢复的大脑机制知之甚少，特别是在身体感觉丧失后。了解可能促进大脑重组的经验是开发和评估最佳中风康复策略的先决条件。我们的目标是提供关于特定训练在促进脑卒中后重组的潜在益处的新信息。具体来说，我们将：(i)定位与中风后自然和训练诱导的触觉恢复相关的大脑活动区域；（ii）研究大脑激活、感觉恢复和干预体验之间的关系。随着时间的推移，将使用系列功能磁共振成像（fMRI），一种受控的感觉任务和临床恢复措施来研究与触觉恢复相关的大脑激活的位置和程度。30例上肢触觉受损的中风患者将在中风后2-6周和6个月进行研究，以调查与自然恢复相关的脑激活变化（研究1）。10名健康对照者也将进行为期6个月的研究。6个月后仍有感觉丧失的患者将接受特定的感觉训练或安慰剂干预，以研究训练诱导的恢复对大脑活动的影响（研究2）。整个大脑将被研究，激活位点将被解释为相对于个体和标准的大脑图谱。我们期望这些发现将推进我们对临床恢复、训练和大脑神经可塑性变化之间关系的认识。这些信息将为科学治疗的发展提供方向，旨在最大限度地恢复，并帮助识别可能表现出自然恢复和或从训练中受益的患者。

Brain networks may reorganize to optimise stroke recovery. However, little is known about brain mechanisms underlying natural and training-induced recovery after stroke, particularly following loss of body sensations. Knowledge of the experiences that may facilitate brain reorganisation is a prerequisite for the development and evaluation of optimal stroke rehabilitation strategies. We aim to provide novel information on the potential benefits of specific training in facilitating reorganisation of the brain after stroke. Specifically we will: (i) locate areas of brain activity associated with natural and training-induced recovery of touch sensation following stroke and (ii) investigate the relationship between brain activation, sensory recovery and intervening experience. Site and extent of brain activation associated with recovery of touch sensation will be investigated over time using serial functional magnetic resonance imaging (fMRI), a controlled sensory task and clinical measures of recovery. Thirty stroke patients with impaired touch sensation of the upper limb will be studied at 2-6 weeks and 6 months post-stroke to investigate changes in brain activation associated with natural recovery (Study 1). Ten healthy controls will also be studied over 6 months. Those patients who still have sensory loss at 6 months will then receive specific sensory training or placebo intervention to study the effect of training-induced recovery on brain activity (Study 2). The whole brain will be studied and activation sites will be interpreted relative to individual and standard brain maps. We expect that the findings will advance our knowledge of the relationship between clinical recovery, training and neural plastic changes in the brain. This information will provide direction for the development of scientifically based treatments designed to maximise recovery and help identify patients who are likely to show natural recovery and-or benefit from training.