Functional Brain Reorganization in stroke Recovery

中风后基本感觉、运动以及高级认知和语言功能的恢复过程尚不清楚。同样鲜为人知的是调节治疗有效性的神经生理机制，如约束诱导治疗(CIT)，它被认为可以促进康复过程。然而，有人提出，从根本上说，恢复是大脑功能重组的结果。在功能神经成像出现之前，支持这一概念的证据完全是来自临床或行为数据的间接推断。然而，最近，我们和其他人已经开始使用脑磁图(MEG)和其他功能神经成像方法 积累了大脑可塑性和功能重组的直接证据。在这个计划项目中，我们计划利用脑磁图的大脑激活图谱，系统地研究中风自然恢复期间下列行为和认知功能的重组程度和类型：第一，表达和接受语言；第二，运动；第三，躯体感觉和空间注意功能。我们还计划研究用于促进语言和感觉运动功能恢复过程的CIT对这些激活曲线的影响。我们预计，观察到的重组的程度和类型将随着损伤参数的不同而不同，通过结构磁共振和神经心理测试进行评估。最后，我们将尝试再次使用脑磁图来说明受损功能的机制重组对不受中风影响的功能机制的影响。

The process of recovery of basic sensory, motor, and higher cognitive and linguistic functions, following stroke, is not well understood. Also poorly understood are the neurophysiological mechanisms that mediate the effectiveness of therapies, like the Constraint-Induced Therapy (CIT), which are reputed to enhance the recovery process. It has been suggested, however, that, fundamentally, recovery is a result of functional reorganization of the brain. Before the advent of functional neuroimaging, evidence supporting this notion consisted entirely of indirect inferences from clinical or behavioral data. Recently, however, we and others, using Magnetoencephalography (MEG) and other functional neuroimaging methods, have begun accumulating direct evidence of brain plasticity and functional reorganization. In this Program Project we plan to investigate systematically the extent and type of reorganization, using MEG-derived brain activation profiles, during spontaneous recovery from stroke, of the following behavioral and cognitive functions: First, expressive and receptive language; second, motor; and third, somatosensory and spatial attention functions. We also plan to study the effects of CIT used to enhance the recovery process of language and sensorimotor functions, on these activation profiles. We expect that the extent and type of reorganization observed will vary as a function of lesion parameters, assessed through structural MRI, and neuropsychological testing. Finally, we will attempt to specify the repercussions of reorganization of the mechanisms of the compromised functions for the mechanisms of functions unaffected by the stroke using, once again, MEG mapping.