The plasticity of intrinsic functional connectivity patterns associated with rehabilitation intervention in chronic stroke patients
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It has been demonstrated that rehabilitative interventions can promote motor function recovery in stroke patients. However, little is known regarding the neural mechanisms that underlie the rehabilitation treatments. The aim of this study was to investigate the plasticity of intrinsic functional connectivity patterns that are associated with rehabilitation intervention in chronic stroke patients.
Twelve chronic stroke patients with subcortical lesions in the left motor pathway participated in a 4-week rehabilitation intervention and underwent resting-state functional magnetic resonance imaging (fMRI) scanning before and after the intervention. Both functional connectivity analyses of the ipsilesional (left) primary motor cortex (M1) and measurements of the lateralization index of the connectivity patterns were performed in both the stroke patients and healthy controls (HC).
Compared with the HC, the decreased connectivity of the ipsilesional M1 with the contralesional sensorimotor cortex (SMC), bilateral supplementary motor areas, and inferior parietal lobule due to stroke were remarkably restored after the intervention. More specifically, the lateralization index of the bilateral SMC tends to be the normal level. Moreover, comparing post- with pre-intervention, we observed significantly increased connectivity of ipsilesional M1 with the contralesional M1 and medial superior frontal gyrus (mSFG). Additionally, the index of pre-intervention connectivity with the contralesional mSFG was positively correlated with motor improvement.
The impact of rehabilitation intervention on intrinsic functional connectivity patterns throughout the brain was measurable on resting-state fMRI, and systematic assessment of resting-state functional connectivity can provide prognostic insight for later motor improvement.
KeywordsResting state Function connectivity Motor recovery Rehabilitation intervention Stroke
This research was supported by the China National Nature Science Foundation (grant no. 81471651), the China National Nature Science Young Foundation (grant no. 81401859), the 12th Five-Year Plan supporting project of Ministry of Science and Technology of the People’s Republic of China (grant no. 2013BAI10B03), the Shanghai Zhabei District Health Bureau (grant no. 2014MS06) and the Shanghai Commission of Healthy and Family Planning (grant no. 201440634). We would like to thank all of the volunteers and stroke patients for their participation in this study.
Compliance with ethical standards
We declare that all human and animal studies have been approved by the Institutional Ethics Committee of East China Normal University, Shanghai, China, and have therefore been performed in accordance with the ethical laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.
Conflict of interest
We declare that we have no conflict of interest.
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