Synchrony Between Default-Mode and Sensorimotor Networks Facilitates Motor Function in Stroke Rehabilitation: A Pilot fMRI Study

Frontiers in Neuroscience

Li-Ming Hsu¹  Changwei W. Wu²  Chun-Chuan Chen³  Shih-Ching Yeh⁴  Si-Huei Lee⁵  Shiao-Fei Guu⁶  Shang-Hua N. Lin⁷ 

[1] Biomedical Research Imaging Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States;Brain and Consciousness Research Center, College of Humanities and Social Sciences, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan;Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan;Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan;Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan;Graduate Institute of Mind, Brain and Consciousness, College of Humanities and Social Sciences, Taipei Medical University, Taipei, Taiwan;Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan;

关键词: stroke;    rehabilitation;    neuroplasticity;    motor;    resting-state functional MRI;    functional connectivity;   

DOI  :  10.3389/fnins.2020.00548

来源: DOAJ

【 摘 要 】

Stroke is the most common cause of complex disability in Taiwan. After stroke onset, persistent physical practice or exercise in the rehabilitation procedure reorganizes neural assembly for reducing motor deficits, known as neuroplasticity. Neuroimaging literature showed rehabilitative effects specific to the brain networks of the sensorimotor network (SMN) and default-mode network (DMN). However, whether between-network interactions facilitate the neuroplasticity after stroke rehabilitation remains a mystery. Therefore, we conducted the longitudinal assessment protocol of stroke rehabilitation, including three types of clinical evaluations and two types of functional magnetic resonance imaging (fMRI) techniques (resting state and grasp task). Twelve chronic stroke patients completed the rehabilitation protocol for at least 24 h and finished the three-time assessments: before, after rehabilitation, and 1 month after the cessation of rehabilitation. For comparison, age-matched normal controls (NC) underwent the same fMRI evaluation once without repeated measure. Increasing scores of the Fugl–Meyer assessment (FMA) and upper extremity performance test reflected the enhanced motor performances after the stroke rehabilitation process. Analysis of covariance (ANCOVA) results showed that the connections between posterior cingulate cortex (PCC) and iM1 were persistently enhanced in contrast to the pre-rehabilitation condition. The interactions between PCC and SMN were positively associated with motor performances. The enhanced cross-network connectivity facilitates the motor recovery after stroke rehabilitation, but the cross-network interaction was low before the rehabilitation process, similar to the level of NCs. Our findings suggested that cross-network connectivity plays a facilitatory role following the stroke rehabilitation, which can serve as a neurorehabilitative biomarker for future intervention evaluations.

【 授权许可】

Unknown