Brunetti Maddalena, Morkisch Nadine, Fritzsch Claire, Mehnert Jan, Steinbrink Jens, Niedeggen Michael, Dohle Christian
MEDIAN Klinik Berlin-Kladow, Kladower Damm, Berlin, Germany.
Departments of Educational Science and Psychology, Freie Universität Berlin, Habelschwerdter Allee, Berlin, Germany.
Restor Neurol Neurosci. 2015;33(4):421-34. doi: 10.3233/RNN-140421.
Mirror therapy (MT) was found to improve motor function after stroke. However, there is high variability between patients regarding motor recovery.
The following pilot study was designed to identify potential factors determining this variability between patients with severe upper limb paresis, receiving MT.
Eleven sub-acute stroke patients with severe upper limb paresis participated, receiving in-patient rehabilitation. After a set of pre-assessments (including measurement of brain activity at the primary motor cortex and precuneus during the mirror illusion, using near-infrared spectroscopy as described previously), four weeks of MT were applied, followed by a set of post-assessments. Discriminant group analysis for MT responders and non-responders was performed.
Six out of eleven patients were defined as responders and five as non-responders on the basis of their functional motor improvement. The initial motor function and the activity shift in both precunei (mirror index) were found to discriminate significantly between responders and non-responders.
In line with earlier results, initial motor function was confirmed as crucial determinant of motor recovery. Additionally, activity response to the mirror illusion in both precunei was found to be a candidate for determination of the efficacy of MT.
镜像疗法(MT)被发现可改善中风后的运动功能。然而,患者之间的运动恢复存在很大差异。
以下初步研究旨在确定决定接受MT治疗的严重上肢麻痹患者之间这种差异的潜在因素。
11名患有严重上肢麻痹的亚急性中风患者参与,接受住院康复治疗。在进行一组预评估(包括如前所述使用近红外光谱法在镜像错觉期间测量初级运动皮层和楔前叶的脑活动)后,应用四周的MT,随后进行一组后评估。对MT反应者和无反应者进行判别组分析。
根据其运动功能改善情况,11名患者中有6名被定义为反应者,5名被定义为无反应者。发现初始运动功能和两个楔前叶的活动变化(镜像指数)在反应者和无反应者之间有显著差异。
与早期结果一致,初始运动功能被确认为运动恢复的关键决定因素。此外,发现两个楔前叶对镜像错觉的活动反应是决定MT疗效的一个候选因素。