Dong Yun, Dobkin Bruce H, Cen Steven Y, Wu Allan D, Winstein Carolee J
Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
Stroke. 2006 Jun;37(6):1552-5. doi: 10.1161/01.STR.0000221281.69373.4e. Epub 2006 Apr 27.
Functional brain imaging after stroke offers insight into motor network adaptations. This exploratory study examined whether motor cortical activation captured during arm-focused therapy can predict paretic hand functional gains.
Eight hemiparetic patients had serial functional MRI (fMRI) while performing a pinch task before, midway, and after 2 weeks of constraint-induced therapy. The Wolf Motor Function Test (WMFT) was performed before and after intervention.
There was a linear reduction in ipsilateral (contralesional) primary motor (M1) activation (voxel counts) across time. The midpoint M1 Laterality Index anticipated post-therapeutic change in time to perform the WMFT. The change in ipsilateral M1 voxel count (pre- to mid-) correlated with the change in mean WMFT time (pre- to post-).
The relationship between brain activation during treatment and functional gains suggests a use for serial fMRI in predicting the success and optimal duration for a focused therapeutic intervention.
中风后的脑功能成像有助于深入了解运动网络的适应性变化。本探索性研究旨在检验在以手臂为重点的治疗过程中所捕捉到的运动皮层激活情况是否能够预测偏瘫手功能的改善。
8名偏瘫患者在进行为期2周的强制性诱导治疗前、治疗中期和治疗后，执行捏取任务时接受了系列功能磁共振成像（fMRI）检查。在干预前后进行了Wolf运动功能测试（WMFT）。
同侧（对侧）初级运动皮层（M1）激活（体素计数）随时间呈线性减少。中点M1偏侧指数可预测治疗后完成WMFT的时间变化。同侧M1体素计数的变化（治疗前至治疗中期）与平均WMFT时间的变化（治疗前至治疗后）相关。
治疗期间脑激活与功能改善之间的关系表明，系列fMRI可用于预测针对性治疗干预的成功与否及最佳持续时间。
